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Breaking news about genomic engineering, T2DM and cancer treatments – 9/28/2015

Larry H Bernstein, MD, FCAP, Curator

LPBI

Newly Identified Biochemical Pathway Could Be Target For Insulin Control

Mon, 09/28/2015  Duke University

2.1.3.12

2.1.3.12   Breaking News about Genomic Engineering, T2DM and Cancer Treatments – 9/28/2015, Volume 2 (Volume Two: Latest in Genomics Methodologies for Therapeutics: Gene Editing, NGS and BioInformatics, Simulations and the Genome Ontology), Part 2: CRISPR for Gene Editing and DNA Repair

In the final event leading to the development of Typ 2 diabetes, the pancreas loses its ability to secrete insulin and clear glucose from the blood. Preventing this breakdown in insulin secretion is a key goal in the fight to reduce the burden of a disease that afflicts an estimated 29 million people in the United States.

Now researchers at Duke Medicine and the University of Alberta are reporting the identification of a new biochemical pathway to control insulin secretion from islet beta cells in the pancreas, establishing a potential target for insulin control.

The study, published online Sept. 24 in the journal Cell Reports, results from a field of work called metabolomics, which uses mass spectrometry instruments to measure and trace intermediate molecules in key metabolic pathways of cells and tissues.

“The Duke group focused on metabolites in islet cells that changed in response to elevated external glucose concentrations,” said co-senior author Christopher B. Newgard, Ph.D., director of the Sarah W. Stedman Nutrition and Metabolism Center and the Duke Molecular Physiology Institute. “We found a strong increase in an intermediate in the purine/nucleotide metabolic pathway — known as adenylosuccinate, or S-AMP — in islets stimulated with glucose.”

Impairment of S-AMP production was shown to interfere with normal glucose-stimulated insulin secretion. The Duke and University of Alberta Diabetes Institute teams were also able to demonstrate that S-AMP is capable of rescuing impaired insulin secretion in islets from people with Type 2 diabetes.

Newgard said the collaborative effort between the Duke and Alberta teams also yielded a separate finding, reported online Sept. 21 in the Journal of Clinical Investigation, which describes another molecular pathway that could be a potential metabolic target for insulin control.

In that study, the research teams identified a process that works essentially like a dimmer switch to adjust how much or how little insulin is secreted when blood sugar increases. This dimmer switch appears to be broken in Type 2 diabetes, but the researchers found that its function can be restored.

“For the moment, we have two separate mechanisms, but with further study we may find that they are more connected,” Newgard said. “Whether they are independent, additive or synergistic is unknown, so we are eager to bring the two projects together to see where that may lead.”

The National Institutes of Health and the Canadian Institutes of Health Research  funded the research.

Source: Duke University

http://www.biosciencetechnology.com/news/2015/09/newly-identified-biochemical-pathway-could-be-target-insulin-control?

Tissue-Specific Molecular Biomarker Signatures of Type 2 Diabetes

An Integrative Analysis of Transcriptomics and Protein–Protein Interaction Data

Beste Calimlioglu, Kubra Karagoz, Tuba Sevimoglu, Elif Kilic, Esra Gov, Kazim Yalcin Arga

http://www.genengnews.com/media/images/AnalysisAndInsight/Sep23_2015_YOmerAkyol_Type2Diabetes1291421046.jpg

Type2Diabetes -Sep23_2015_YOmerAkyol_1291421046

Mutual DEGs between only two different tissues/cells. [Y. Omer Akyol]

  • Type 2 diabetes mellitus (T2D) is a major global health burden. A complex metabolic disease, type 2 diabetes affects multiple different tissues, demanding a ‘‘systems medicine’’ approach to biomarker and novel diagnostic discovery, not to mention data integration across omics-es (Günther et al. 2014; Montague et al. 2014; Sahu et al. 2014). The two important key determinants of T2D are the failure of peripheral tissues (such as liver, muscle, and adipose tissue) to respond to insulin doses (so-called insulin resistance), and the failure of suitable insulin secretion by pancreatic beta cells in response to increased blood glucose levels (Kaiser and Oetjen, 2014).

The duration of hyperglycemia caused by failure of betacells also affects insulin secretory capacity, mass, and apoptosis rate of beta-cells, resulting in additional alterations in several processes such as islet inflammation, amyloid deposition, critical B-cell alterations (Prentki and Nolan, 2006). On the other hand, the state of hyperglycemia dama
ges nerves and blood vessels, leading to major healthrelated issues such as cardiovascular diseases, stroke, blindness, dental problems, and diabetes-related amputations. Other complications of T2D include enhanced vulnerability to neurodegenerative diseases, presence of various cancer types, pregnancy problems, loss of mobility with aging, and depression (Musselman et al., 2003; Retnakaran et al., 2006).

Due to the high prevalence of T2D and its fateful complications, identifying the genes or genetic factors associated with the development of T2D and elucidating the mechanisms underlying the disease are crucial in prognosis, and development of personalized medicine and therapeutic strategies.

Since it is a polygenic disorder (i.e., multiple genes located on different chromosomes take active roles in the development of the disease), it is better to reveal that gene expression varies more across tissues than across individuals. Several studies reported findings on T2D gene expression profiles of
different tissues individually (Kazier et al., 2007; Cangemi et al., 2011; Misu et al., 2010; van Tienen et al., 2012; Dominguez et al., 2011). Despite individual studies exploring T2D specific genes in various tissues, studies considering the meta-analysis of diverse transcriptomics datasets and integrating gene expression profiles with biological networks are very limited.

Keller and co-workers (2008) studied gene expression profiles in eight experimental groups of lean and obese mice.

To read the rest of this article click here.

OMICS: A Journal of Integrative Biology integrates global high-throughput and systems approaches to 21st century science from “cell to society” – seen from a post-genomics perspective. The above article was first published in the September 2015 issue of OMICS: A Journal of Integrative Biology with the title “Tissue-Specific Molecular Biomarker Signatures of Type 2 Diabetes: An Integrative Analysis of Transcriptomics and Protein–Protein Interaction Data”. The views expressed here are those of the authors and are not necessarily those of OMICS: A Journal of Integrative Biology, Mary Ann Liebert, Inc., publishers, or their affiliates. No endorsement of any entity or technology is implied.

http://www.genengnews.com/insight-and-intelligence/tissue-specific-molecular-biomarker-signatures-of-type-2-diabetes/77900522/

Newly Identified Biochemical Pathway Could Be Target For Insulin Control

9/28/2015 Duke University

In the final event leading to the development of Type 2 diabetes, the pancreas loses its ability to secrete insulin and clear glucose from the blood. Preventing this breakdown in insulin secretion is a key goal in the fight to reduce the burden of a disease that afflicts an estimated 29 million people in the United States.

Now researchers at Duke Medicine and the University of Alberta are reporting the identification of a new biochemical pathway to control insulin secretion from islet beta cells in the pancreas, establishing a potential target for insulin control.

The study, published online Sept. 24 in the journal Cell Reports, results from a field of work called metabolomics, which uses mass spectrometry instruments to measure and trace intermediate molecules in key metabolic pathways of cells and tissues.

“The Duke group focused on metabolites in islet cells that changed in response to elevated external glucose concentrations,” said co-senior author Christopher B. Newgard, Ph.D., director of the Sarah W. Stedman Nutrition and Metabolism Center and the Duke Molecular Physiology Institute. “We found a strong increase in an intermediate in the purine/nucleotide metabolic pathway — known as adenylosuccinate, or S-AMP — in islets stimulated with glucose.”

Impairment of S-AMP production was shown to interfere with normal glucose-stimulated insulin secretion. The Duke and University of Alberta Diabetes Institute teams were also able to demonstrate that S-AMP is capable of rescuing impaired insulin secretion in islets from people with Type 2 diabetes.

Newgard said the collaborative effort between the Duke and Alberta teams also yielded a separate finding, reported online Sept. 21 in the Journal of Clinical Investigation, which describes another molecular pathway that could be a potential metabolic target for insulin control.

In that study, the research teams identified a process that works essentially like a dimmer switch to adjust how much or how little insulin is secreted when blood sugar increases. This dimmer switch appears to be broken in Type 2 diabetes, but the researchers found that its function can be restored.

“For the moment, we have two separate mechanisms, but with further study we may find that they are more connected,” Newgard said. “Whether they are independent, additive or synergistic is unknown, so we are eager to bring the two projects together to see where that may lead.”

The National Institutes of Health and the Canadian Institutes of Health Research funded the research.

Source: Duke University

http://www.biosciencetechnology.com/news/2015/09/newly-identified-biochemical-pathway-could-be-target-insulin-control?

Read Full Post »

Confluence of Chemistry, Physics, and Biology

Curator: Larry H. Bernstein, MD, FCAP

 

  1. How Nanotechnology Works by Kevin Bonsor and Jonathan Strickland

nanotechnology-4

Image Source:
http://s.hswstatic.com/gif/nanotechnology-4.gif

There’s an unprecedented multidisciplinary convergence of scientists dedicated to the study of a world so small, we can’t see it — even with a light microscope. That world is the field of nanotechnology, the realm ofatoms and nanostructures.Nanotechnology i­s so new, no one is really sure what will come of it. Even so, predictions range from the ability to reproduce things like diamonds and food to the world being devoured by self-replicating nanorobots.In order to understand the unusual world of nanotechnology, we need to get an idea of the units of measure involved. A centimeter is one-hundredth of a meter, a millimeter is one-thousandth of a meter, and a micrometer is one-millionth of a meter, but all of these are still huge compared to the nanoscale. A nanometer (nm) is one-billionth of a meter, smaller than the wavelength of visible light and a hundred-thousandth the width of a human hair

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As small as a nanometer is, it’s still large compared to the atomic scale. An atom has a diameter of about 0.1 nm. An atom’s nucleus is much smaller — about 0.00001 nm. Atoms are the building blocks for all matter in our universe. You and everything around you are made of atoms. Nature has perfected the science of manufacturing matter molecularly. For instance, our bodies are assembled in a specific manner from millions of living cells. Cells are nature’s nanomachines. At the atomic scale, elements are at their most basic level. On the nanoscale, we can potentially put these atoms together to make almost anything.

In a lecture called “Small Wonders:The World of Nanoscience,” Nobel Prize winner Dr. Horst Störmer said that the nanoscale is more interesting than the atomic scale because the nanoscale is the first point where we can assemble something — it’s not until we start putting atoms together that we can make anything useful.

In this article, we’ll learn about what nanotechnology means today and what the future of nanotechnology may hold. We’ll also look at the potential risks that come with working at the nanoscale.

In the next section, we’ll learn more about our world on the nanoscale.

The World of Nanotechnology

Experts sometimes disagree about what constitutes the nanoscale, but in general, you can think ofnanotechnology dealing with anything measuring between 1 and 100 nm. Larger than that is the microscale, and smaller than that is the atomic scale.

Nanotechnology is rapidly becoming an interdisciplinary field. Biologists, chemists, physicists and engineers are all involved in the study of substances at the nanoscale. Dr. Störmer hopes that the different disciplines develop a common language and communicate with one another

nanotechnology-5

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Only then, he says, can we effectively teach nanoscience since you can't understand the world of nanotechnology without a solid background in multiple sciences.

One of the exciting and challenging aspects of the nanoscale is the role that quantum mechanics plays in it. The rules of quantum mechanics are very different from classical physics, ­which means that the behavior of substances at the nanoscale can sometimes contradict common sense by behaving erratically. You can’t walk up to a wall and immediately teleport to the other side of it, but at the nanoscale an electron can — it’s called electron tunneling. Substances that are insulators, meaning they can’t carry an electric charge, in bulk form might become semiconductors when reduced to the nanoscale. Melting points can change due to an increase in surface area. Much of nanoscience requires that you forget what you know and start learning all over again.

So what does this all mean? Right now, it means that scientists are experimenting with substances at the nanoscale to learn about their properties and how we might be able to take advantage of them in various applications. Engineers are trying to use nano-size wires to create smaller, more powerful microprocessors. Doctors are searching for ways to use nanoparticles in medical applications. Still, we’ve got a long way to go before nanotechnology dominates the technology and medical markets.

In the next section, we’ll look at two important nanotechnology structures: nanowires and carbon nanotubes.

IT’S A SMALL WORLD AFTER ALL

At the nanoscale, objects are so small that we can’t see them — even with a light microscope. Nanoscientists have to use tools like scanning tunneling microscopes or atomic force microscopes to observe anything at the nanoscale. Scanning tunneling microscopes use a weak electric current to probe the scanned material. Atomic force microscopes scan surfaces with an incredibly fine tip. Both microscopes send data to a computer, which can assemble the information and project it graphically onto a monitor

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nanotechnology-6

http://s.hswstatic.com/gif/nanotechnology-6.gif

Nanowires and Carbon Nanotubes

Currently, scientists find two nano-size structures of particular interest: nanowires and carbon nanotubes. Nanowires are wires with a very small diameter, sometimes as small as 1 nanometer. Scientists hope to use them to build tiny transistors for computer chips and other electronic devices. In the last couple of years, carbon nanotubes have overshadowed nanowires. We’re still learning about these structures, but what we’ve learned so far is very exciting.

A carbon nanotube is a nano-size cylinder of carbon atoms. Imagine a sheet of carbon atoms, which would look like a sheet of hexagons. If you roll that sheet into a tube, you’d have a carbon nanotube. Carbon nanotube properties depend on how you roll the sheet. In other words, even though all carbon nanotubes are made of carbon, they can be very different from one another based on how you align the individual atoms.

With the right arrangement of atoms, you can create a carbon nanotube that’s hundreds of times stronger than steel, but six times lighter

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Engineers plan to make building material out of carbon nanotubes, particularly for things like cars and airplanes. Lighter vehicles would mean better fuel efficiency, and the added strength translates to increased passenger safety.

Carbon nanotubes can also be effective semiconductors with the right arrangement of atoms. Scientists are still working on finding ways to make carbon nanotubes a realistic option for transistors in microprocessors and other electronics.

In the next section, we’ll look at products that are taking advantage of nanotechnology.

GRAPHITE VS. DIAMONDS

What’s the difference between graphite and diamonds? Both materials are made of carbon, but both have vastly different properties. Graphite is soft; diamonds are hard. Graphite conducts electricity, but diamonds are insulators and can’t conduct electricity. Graphite is opaque; diamonds are usually transparent. Graphite and diamonds have these properties because of the way the carbon atoms bond together at the nanoscale.

Products with Nanotechnology

You might be surprised to find out how many products on the market are already benefiting from nanotechnology.

Bridgestone engineers developed this Quick Response Liquid Powder Display, a flexible digital screen, using nanotechnology.

Yoshikazu Tsuno/AFP/Getty Images

  • Sunscreen – Many sunscreens contain nanoparticles of zinc oxide or titanium oxide. Older sunscreen formulas use larger particles, which is what gives most sunscreens their whitish color. Smaller particles are less visible, meaning that when you rub the sunscreen into your skin, it doesn’t give you a whitish tinge.
  • Self-cleaning glass – A company called Pilkington offers a product they call Activ Glass, which uses nanoparticles to make the glassphotocatalytic and hydrophilic. The photocatalytic effect means that when UV radiation from light hits the glass, nanoparticles become energized and begin to break down and loosen organic molecules on the glass (in other words, dirt). Hydrophilic means that when water makes contact with the glass, it spreads across the glass evenly, which helps wash the glass clean.
  • Clothing – Scientists are using nanoparticles to enhance your clothing. By coating fabrics with a thin layer of zinc oxide nanoparticles, manufacturers can create clothes that give better protection from UV radiation. Some clothes have nanoparticles in the form of little hairs or whiskers that help repel water and other materials, making the clothing stain-resistant.
  • Scratch-resistant coatings – Engineers discovered that adding aluminum silicate nanoparticles to scratch-resistant polymer coatings made the coatings more effective, increasing resistance to chipping and scratching. Scratch-resistant coatings are common on everything from cars to eyeglass lenses.
  • Antimicrobial bandages – Scientist Robert Burrell created a process to manufacture antibacterial bandages using nanoparticles of silver. Silver ions block microbes’ cellular respiration

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    . In other words, silver smothers harmful cells, killing them.

New products incorporating nanotechnology are coming out every day. Wrinkle-resistant fabrics, deep-penetrating cosmetics, liquid crystal displays (LCD) and other conveniences using nanotechnology are on the market. Before long, we’ll see dozens of other products that take advantage of nanotechnology ranging from Intel microprocessors to bio-nanobatteriescapacitors only a few nanometers thick. While this is exciting, it’s only the tip of the iceberg as far as how nanotechnology may impact us in the future.

In the next section, we’ll look at some of the incredible things that nanotechnology may hold for us.­

TENNIS, ANYONE?

Nanotechnology is making a big impact on the tennis world. In 2002, the tennis racket company Babolat introduced the VS Nanotube Power racket. They made the racket out of carbon nanotube-infused graphite, meaning the racket was very light, yet many times stronger than steel. Meanwhile, tennis ball manufacturer Wilson introduced the Double Core tennis ball. These balls have a coating of clay nanoparticles on the inner core. The clay acts as a sealant, making it very difficult for air to escape the ball.

Accelerate Your Time to Print Using ANSYS™ SpaceClaim 2015

Switching between multiple tools to prepare 3D models for printing is not only time consuming, but also inefficient and costly to maintain. In the 2015 release, ANSYS SpaceClaim has honed its 3D printing capabilities while adding a multitude of new features to streamline model preparation, providing you with the best 3D printing model prep solution.

ANSYS™ SpaceClaim 2015 provides new features to the STL Prep module, including:

  1. A one-click tool for adding a desired thickness to a part for printing
  2. Automatic facet smoothing for building precision into 3D parts
  3. A minimum thickness detection feature to check for areas falling below a tolerance limit
  4. An unsupported material warning with an overhangs button to add support material where it is needed

http://www.spaceclaim.com/en/Mkting/ppc_SpaceClaim2015_FacetedModels_Video_ThankYou.aspx

The Future of Nanotechnology

In the world of “Star Trek,” machines called replicators can produce practically any physical object, from weapons to a steaming cup of Earl Grey tea. Long considered to be exclusively the product of science fiction, today some people believe replicators are a very real possibility. They call it molecular manufacturing, and if it ever does become a reality, it could drastically change the world.

http://s.hswstatic.com/gif/nanotechnology-7.gif

Atoms and molecules stick together because they have complementary shapes that lock together, or charges that attract. Just like with magnets, a positively charged atom will stick to a negatively charged atom. As millions of these atoms are pieced together by nanomachines, a specific product will begin to take shape. The goal of molecular manufacturing is to manipulate atoms individually and place them in a pattern to produce a desired structure.

The first step would be to develop nanoscopic machines, called assemblers, that scientists can program to manipulate atoms and molecules at will. Rice University Professor Richard Smalley points out that it would take a single nanoscopic machine millions of years to assemble a meaningful amount of material. In order for molecular manufacturing to be practical, you would need trillions of assemblers working together simultaneously. Eric Drexler believes that assemblers could first replicate themselves, building other assemblers. Each generation would build another, resulting in exponential growth until there are enough assemblers to produce objects

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Assemblers might have moving parts like the nanogears in this concept drawing.

Trillions of assemblers and replicators could fill an area smaller than a cubic millimeter, and could still be too small for us to see with the naked eye. Assemblers and replicators could work together to automatically construct products, and could eventually replace all traditional labor methods. This could vastly decrease manufacturing costs, thereby making consumer goods plentiful, cheaper and stronger. Eventually, we could be able to replicate anything, including diamonds, water and food. Famine could be eradicated by machines that fabricate foods to feed the hungry.

Nanotechnology may have its biggest impact on the medical industry. Patients will drink fluids containing nanorobots programmed to attack and reconstruct the molecular structure of cancer cells and viruses. There’s even speculation that nanorobots could slow or reverse the aging process, and life expectancy could increase significantly. Nanorobots could also be programmed to perform delicate surgeries — suchnanosurgeons could work at a level a thousand times more precise than the sharpest scalpel

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By working on such a small scale, a nanorobot could operate without leaving the scars that conventional surgery does. Additionally, nanorobots could change your physical appearance. They could be programmed to perform cosmetic surgery, rearranging your atoms to change your ears, nose, eye color or any other physical feature you wish to alter.

Nanotechnology has the potential to have a positive effect on the environment. For instance, scientists could program airborne nanorobots to rebuild the thinning ozone layer. Nanorobots could remove contaminants from water sources and clean up oil spills. Manufacturing materials using the bottom-upmethod of nanotechnology also creates less pollution than conventional manufacturing processes. Our dependence on non-renewable resources would diminish with nanotechnology. Cutting down trees, mining coal or drilling for oil may no longer be necessary — nanomachines could produce those resources.

Many nanotechnology experts feel that these applications are well outside the realm of possibility, at least for the foreseeable future. They caution that the more exotic applications are only theoretical. Some worry that nanotechnology will end up like virtual reality — in other words, the hype surrounding nanotechnology will continue to build until the limitations of the field become public knowledge, and then interest (and funding) will quickly dissipate.

In the next section, we’ll look at some of the challenges and risks of nanotechnology.

HOW NEW IS NANOTECHNOLOGY?

In 1959, physicist and future Nobel prize winner Richard Feynman gave a lecture to the American Physical Society called “There’s Plenty of Room at the Bottom.” The focus of his speech was about the field of miniaturization and how he believed man would create increasingly smaller, powerful devices.

In 1986, K. Eric Drexler wrote “Engines of Creation” and introduced the term nanotechnology. Scientific research really expanded over the last decade. Inventors and corporations aren’t far behind — today, more than 13,000 patents registered with the U.S. Patent Office have the word “nano” in them

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Nanotechnology Challenges, Risks and Ethics

http://s.hswstatic.com/gif/nanotechnology-5.gif

The most immediate challenge in nanotechnology is that we need to learn more about materials and their properties at the nanoscale. Universities and corporations across the world are rigorously studying how atoms fit together to form larger structures. We’re still learning about how quantum mechanics impact substances at the nanoscale.

Because elements at the nanoscale behave differently than they do in their bulk form, there’s a concern that some nanoparticles could be toxic. Some doctors worry that the nanoparticles are so small, that they could easily cross the blood-brain barrier, a membrane that protects the brain from harmful chemicals in the bloodstream. If we plan on using nanoparticles to coat everything from our clothing to our highways, we need to be sure that they won’t poison us.

Closely related to the knowledge barrier is the technical barrier. In order for the incredible predictions regarding nanotechnology to come true, we have to find ways to mass produce nano-size products like transistors and nanowires. While we can use nanoparticles to build things like tennis rackets and make wrinkle-free fabrics, we can’t make really complex microprocessor chips with nanowires yet.

There are some hefty social concerns about nanotechnology too. Nanotechnology may also allow us to create more powerful weapons, both lethal and non-lethal. Some organizations are concerned that we’ll only get around to examining the ethical implications of nanotechnology in weaponry after these devices are built. They urge scientists and politicians to examine carefully all the possibilities of nanotechnology before designing increasingly powerful weapons.

If nanotechnology in medicine makes it possible for us to enhance ourselves physically, is that ethical? In theory, medical nanotechnology could make us smarter, stronger and give us other abilities ranging from rapid healing to night vision. Should we pursue such goals? Could we continue to call ourselves human, or would we become transhuman — the next step on man’s evolutionary path? Since almost every technology starts off as very expensive, would this mean we’d create two races of people — a wealthy race of modified humans and a poorer population of unaltered people? We don’t have answers to these questions, but several organizations are urging nanoscientists to consider these implications now, before it becomes too late.

Not all questions involve altering the human body — some deal with the world of finance and economics. If molecular manufacturing becomes a reality, how will that impact the world’s economy? Assuming we can build anything we need with the click of a button, what happens to all the manufacturing jobs? If you can create anything using a replicator, what happens to currency? Would we move to a completely electronic economy? Would we even need money?

Whether we’ll actually need to answer all of these questions is a matter of debate. Many experts think that concerns like grey goo and transhumans are at best premature, and probably unnecessary. Even so, nanotechnology will definitely continue to impact us as we learn more about the enormous potential of the nanoscale.

APOCALYPTIC GOO

Eric Drexler, the man who introduced the word nanotechnology, presented a frightening apocalyptic vision — self-replicating nanorobots malfunctioning, duplicating themselves a trillion times over, rapidly consuming the entire world as they pull carbon from the environment to build more of themselves. It’s called the “grey goo” scenario, where a synthetic nano-size device replaces all organic material. Another scenario involves nanodevices made of organic material wiping out the Earth — the “green goo” scenario.

The Technion’s Russell Berrie Nanotechnology Institute is a world-leader in nanotechnology research having made seminal discoveries in the field.

Breakthroughs in Nanotechnology

  • Prof. Ester Segal and a team of Israeli and American researchers find that silicon nanomaterials used for the localized delivery of chemotherapy drugs behave differently in cancerous tumors than they do in healthy tissues. The findings could help scientists better design such materials to facilitate the controlled and targeted release of the chemotherapy drugs to tumors.
  • Associate Professor Alex Leshansky of the Faculty of Chemical Engineering is part of an international team that has created a tiny screw-shaped propeller that can move in a gel-like fluid, mimicking the environment in a living organism. The breakthrough brings closer the day robots that are only nanometers – billionths of a meter – in length, can maneuver and perform medicine inside the human body and possibly inside human cells.
  • Prof. Amit Miller and a team of researchers at the Technion and Boston University have discovered a simple way to control the passage of DNA molecules through nanopore sensors. The breakthrough could lead to low-cost, ultra-fast DNA sequencing that would revolutionize healthcare and biomedical research, and spark major advances in drug development, preventative medicine and personalized medicine.

– Israeli Prime Minister Benjamin Netanyahu presents U.S. President Barack Obama with nano-sized inscribed replicas of the Declarations of Independence of the United States and the State of Israel. The replicas were created by scientists at the Technion’s Russell Berrie Nanotechnology Institute (RBNI). (03/13)

– Prof. Nir Tessler has found a way to generate an electrical field inside solar cells that use inorganic nanocrystals or “quantum dots,” making them more suitable for building an energy-efficient nanocrystal solar cell. (11/11)

– Researchers led by Prof. Wayne Kaplan discover the nature of nanometer-thick layers between different materials and find that they have both solid and liquid properties. The results could enable scientists to improve the resilience of the bond between ceramic materials and metals, two types of materials that “do not like” to come into contact. Applications include cutting tools for metal-working; composites for brake pads; the joins between metal conducting wires and chips in computers; and the application of protective ceramic coatings on jet engine blades. (05/11)

– Israeli President Shimon Peres presents Pope Benedict XVI with a “Nano-Bible” smaller than a pinhead. Created by researchers at the Technion-Israel Institute of Technology, the complete punctuated and vowelized version of the Old Testament takes up just 0.5 square millimeters. The idea to write the Bible on such a tiny surface was conceived by Professor Uri Sivan, the first head of the university’s Russell Berrie Nanotechnology Institute (RBNI). (05/09)

Nanotechnology and medicine

Expert Opinion on Biological Therapy  2003; Volume 3Issue 4, 655-663
Dwaine F Emerich & Christopher G Thanos   http://dx.doi.org:/10.1517/14712598.3.4.655

Nanotechnology, or systems/device manufacture at the molecular level, is a multidisciplinary scientific field undergoing explosive development. The genesis of nanotechnology can be traced to the promise of revolutionary advances across medicine, communications, genomics and robotics. On the surface, miniaturisation provides cost effective and more rapidly functioning mechanical, chemical and biological components. Less obvious though is the fact that nanometre sized objects also possess remarkable self-ordering and assembly behaviours under the control of forces quite different from macro objects. These unique behaviours are what make nanotechnology possible, and by increasing our understanding of these processes, new approaches to enhancing the quality of human life will surely be developed. A complete list of the potential applications of nanotechnology is too vast and diverse to discuss in detail, but without doubt one of the greatest values of nanotechnology will be in the development of new and effective medical treatments (i.e., nanomedicine). This review focuses on the potential of nanotechnology in medicine, including the development of nanoparticles for diagnostic and screening purposes, artificial receptors, DNA sequencing using nanopores, manufacture of unique drug delivery systems, gene therapy applications and the enablement of tissue engineering.

Nanotechnology in Medicine – Nanomedicine

The use of nanotechnology in medicine offers some exciting possibilities. Some techniques are only imagined, while others are at various stages of testing, or actually being used today.

Nanotechnology in medicine involves applications of nanoparticles currently under development, as well as longer range research that involves the use of manufactured nano-robots to make repairs at the cellular level (sometimes referred to as nanomedicine).

Whatever you call it, the use of nanotechnology in the field of medicine could revolutionize the way we detect and treat damage to the human body and disease in the future, and many techniques only imagined a few years ago are making remarkable progress towards becoming realities.

Nanotechnology in Medicine Application: Drug Delivery

One application of nanotechnology in medicine currently being developed involves employing nanoparticles to deliver drugs, heat, light or other substances to specific types of cells (such as cancer cells). Particles are engineered so that they are attracted to diseased cells, which allows direct treatment of those cells. This technique reduces damage to healthy cells in the body and allows for earlier detection of disease.

For example, nanoparticles that deliver chemotherapy drugs directly to cancer cells are under development. Tests are in progress for targeted delivery of chemotherapy drugs and their final approval for their use with cancer patients is pending. One company, CytImmune has published the results of a Phase 1 Clinical Trial of their first targeted chemotherapy drug and another company, BIND Biosciences, has published preliminary results of a Phase 1 Clinical Trial for their first targeted chemotherapy drug and is proceeding with a Phase 2 Clinical Trial.

Researchers at the University of Illinois have demonstated that gelatin nanoparticles can be used to deliver drugs to damaged brain tissue.

Researchers at MIT using nanoparticles to deliver vaccine. The nanoparticles protect the vaccine, allowing the vaccine time to trigger a stronger immune response.

Reserchers are developing a method to release insulin that uses a sponge-like matrix that contains insulin as well as nanocapsules containing an enzyme. When the glucose level rises the nanocapsules release hydrogen ions, which bind to the fibers making up the matrix. The hydrogen ions make the fibers positively charged, repelling each other and creating openings in the matrix through which insulin is released.

Researchers are developing a nanoparticle that can be taken orally and pass through the lining of the intestines into the bloodsteam. This should allow drugs that must now be delivered with a shot to be taken in pill form.

Researchers are also developing a nanoparticle to defeat viruses. The nanoparticle does not actually destroy viruses molecules, but delivers an enzyme that prevents the reproduction of viruses molecules in the patients bloodstream.

Read more about nanomedicine in drug delivery

Nanotechnology in Medicine Application: Therapy Techniques

Researchers have developed “nanosponges” that absorb toxins and remove them from the bloodstream. The nanosponges are polymer nanoparticles coated with a red blood cell membrane. The red blood cell membrane allows the nanosponges to travel freely in the bloodstream and attract the toxins.

Researchers have demonstrated a method to generate sound waves that are powerful, but also tightly focused, that may eventually be used for noninvasive surgery. They use a lens coated with carbon nanotubes to convert light from a laser to focused sound waves. The intent is to develop a method that could blast tumors or other diseased areas without damaging healthy tissue.

Researchers are investigating the use of bismuth nanoparticles to concentrate radiation used in radiation therapy to treat cancer tumors. Initial results indicate that the bismuth nanoparticles would increase the radiation dose to the tumor by 90 percent.

Nanoparticles composed of polyethylene glycol-hydrophilic carbon clusters (PEG-HCC) have been shown to absorb free radicals at a much higher rate than the proteins out body uses for this function. This ability to absorb free radicals may reduce the harm that is caused by the release of free radicals after a brain injury.

Targeted heat therapy is being developed to destroy breast cancer tumors. In this method antibodies that are strongly attracted to proteins produced in one type of breast cancer cell are attached to nanotubes, causing the nanotubes to accumulate at the tumor. Infrared light from a laser is absorbed by the nanotubes and produces heat that incinerates the tumor.

Read more about nanomedicine therapy techniques

Nanotechnology in Medicine Application: Diagnostic Techniques

Reseachers at MIT have developed a sensor using carbon nanotubes embedded in a gel; that can be injected under the skin to monitor the level of nitric oxide in the bloodstream. The level of nitric oxide is important because it indicates inflamation, allowing easy monitoring of imflammatory diseases. In tests with laboratory mice the sensor remained functional for over a year.

Researchers at the University of Michigan are developing a sensor that can detect a very low level of cancer cells, as low as 3 to 5 cancer cells in a one milliliter in a blood sample. They grow sheets of graphene oxide, on which they attach molecules containing an antibody that attaches to the cancer cells. They then tag the cancer cells with fluorescent molecules to make the cancer cells stand out in a microscope.

Researchers have demonstrated a way to use nanoparticles for early diagnosis of infectious disease. The nanoparticles attach to molecules in the blood stream indicating the start of an infection. When the sample is scanned for Raman scattering the nanoparticles enhance the Raman signal, allowing detection of the molecules indicating an infectious disease at a very early stage.

A test for early detection of kidney damage is being developed. The method uses gold nanorodsfunctionalized to attach to the type of protein generated by damaged kidneys. When protein accumulates on the nanorod the color of the nanorod shifts. The test is designed to be done quickly and inexpensively for early detection of a problem.

Read more about nanomedicine diagnostic techniques

Nanotechnology in Medicine Application: Anti-Microbial Techniques

One of the earliest nanomedicine applications was the use of nanocrystalline silver which is  as an antimicrobial agent for the treatment of wounds, as discussed on the Nucryst Pharmaceuticals Corporation website.

A nanoparticle cream has been shown to fight staph infections. The nanoparticles contain nitric oxide gas, which is known to kill bacteria. Studies on mice have shown that using the nanoparticle cream to release nitric oxide gas at the site of staph abscesses significantly reduced the infection.

Burn dressing that is coated with nanocapsules containing antibotics. If a infection starts the harmful bacteria in the wound causes the nanocapsules to break open, releasing the antibotics. This allows much quicker treatment of an infection and reduces the number of times a dressing has to be changed.

A welcome idea in the early study stages is the elimination of bacterial infections in a patient within minutes, instead of delivering treatment with antibiotics over a period of weeks. You can read about design analysis for the antimicrobial nanorobot used in such treatments in the following article: Microbivores: Artifical Mechanical Phagocytes using Digest and Discharge Protocol.

Nanotechnology in Medicine Application: Cell Repair

Nanorobots could actually be programmed to repair specific diseased cells, functioning in a similar way to antibodies in our natural healing processes.  Read about design analysis for one such cell repair nanorobot in this article: The Ideal Gene Delivery Vector: Chromallocytes, Cell Repair Nanorobots for Chromosome Repair Therapy

Nanotechnology in Medicine: Company Directory

Company Product
CytImmune Gold nanoparticles for targeted delivery of drugs to tumors
NanoBio Nanoemulsions for nasal delivery to fight viruses (such as the flu and colds) or through the skin to fight bacteria

More nanomedicine companies

Nanotechnology in Medicine: Resources

National Cancer Institute Alliance for Nanotechnology in Cancer; This alliance includes aNanotechnology Characterization Lab as well as eight Centers of  Cancer Nanotechnology Excellence.

Alliance for NanoHealth; This alliance includes eight research institutions performing collaborative research.

European Nanomedicine platform

The National Institute of Health (NIH) is funding research at eight Nanomedicine Development Centers.

Page 2: Nanomedicine based upon nano-robots

Compiled by Earl Boysen of Hawk’s Perch Technical Writing, LLC and UnderstandingNano.com.

Future impact of nanotechnology on medicine and dentistry

Mallanagouda Patil,1 Dhoom Singh Mehta,2 and Sowjanya Guvva3

J Indian Soc Periodontol. 2008 May-Aug; 12(2): 34–40.

doi:  10.4103/0972-124X.44088  PMCID: PMC2813556

The human characteristics of curiosity, wonder, and ingenuity are as old as mankind. People around the world have been harnessing their curiosity into inquiry and the process of scientific methodology. Recent years have witnessed an unprecedented growth in research in the area of nanoscience. There is increasing optimism that nanotechnology applied to medicine and dentistry will bring significant advances in the diagnosis, treatment, and prevention of disease. Growing interest in the future medical applications of nanotechnology is leading to the emergence of a new field called nanomedicine. Nanomedicine needs to overcome the challenges for its application, to improve the understanding of pathophysiologic basis of disease, bring more sophisticated diagnostic opportunities, and yield more effective therapies and preventive properties. When doctors gain access to medical robots, they will be able to quickly cure most known diseases that hobble and kill people today, to rapidly repair most physical injuries our bodies can suffer, and to vastly extend the human health span. Molecular technology is destined to become the core technology underlying all of 21st century medicine and dentistry. In this article, we have made an attempt to have an early glimpse on future impact of nanotechnology in medicine and dentistry.

Keywords: Nanodentistry, nanomedicine, nanoscience, nanotechnology

INTRODUCTION

The world began without man, and it will complete itself without him. …Cloude Levi Strauss. Winfred Phillips, DSc, said, “You have to be able to fabricate things, you have to be able to analyze things, you have to be able to handle things smaller than ever imagined in ways not done before”.[1] Many researchers believed that in future, scientific devices that are dwarfed by dust mites may one day be capable of grand biomedical miracles.

The vision of nanotechnology introduced in 1959 by late Nobel Physicist Richard P Faynman in dinner talk said, “There is plenty of room at the bottom,”[2] proposed employing machine tools to make smaller machine tools, these are to be used in turn to make still smaller machine tools, and so on all the way down to the atomic level, noting that this is “a development which I think cannot be avoided”. He suggested nanomachines, nanorobots, and nanodevices ultimately could be used to develop a wide range of automically precise microscopic instrumentation and manufacturing tools, could be applied to produce a vast quantities of ultrasmall computers and various nanoscale microscale robots.

Feynman’s idea remained largely undiscussed until the mid-1980s, when the MIT educated engineer K Eric Drexler published “Engines of Creation”, a book to popularize the potential of molecular nanotechnology.[3]

Nano comes from the Greek word for dwarf, usually nanotechnology is defined as the research and development of materials, devices, and systems exhibiting physical, chemical, and biological properties that are different from those found on a larger scale (matter smaller than scale of things like molecules and viruses).[4]

Old rules don’t apply, small things behave differently. Researchers in nanoland are also making really, really small things with astonishing properties like the carbon nanotube. Chris Papadopoulos, a nanotechnology researcher says, “The carbon nanotube is the poster boy for nanotechnology”. It’s is a very thin sheet of graphite that’s formed into a tube, its strength can be harnessed by embedding them in constructive materials, among other applications, nanotubes may be part of future improvements for high-performance air craft.

In nanoland, tiny differences in size can add up to huge differences in function. Ted Sergent, author of The dance of Molecules, says matter is tunable at nanoscale. For example, change the length of a guitar string and you change the sound it makes; change the size of semiconductors called quantum dots, and you change their rainbow of colors from a single material. Sergent made a three-nanometric dot that ‘glows’ blue, and four nanometer dot that glows red and a five nanometer dot that emits infrared rays or heat.

Nanotechnology will affect everything, says William Atkinson, author of Nanoscom. Nanotechnology and the big changes coming from the inconceivably small. It’ll be like a blizzard; snowflakes whose weight you can’t detect can bring a city to a standstill. Nanotechnology is going to be like that.

The unique quantum phenomena that happen at the nanoscale, draw researchers from many different disciplines to the field, including medicine, chemistry, physics, engineering, and others (dentistry).

The scientists in the field of regenerative medicine and tissue engineering are continually looking for new ways to apply the principles of cell transplantation, material science, and bioengineering to construct biological substitutes that will restore and maintain normal function in diseased and injured tissue. Development of more refined means of delivering medications at therapeutic levels to specific sites is an important clinical issue, for applications of such technology in medicine, and dentistry.[5]

Nanomedicine

The field of “Nanomedicine” is the science and technology of diagnosing, treating, and preventing disease and traumatic injury, of relieving pain, and of preserving and improving human health, using nanoscale structured materials, biotechnology, and genetic engineering, and eventually complex machine systems and nonorobots.[5] It was perceived as embracing five main subdisciplines that in many ways are overlapping by common technical issues [Figure 1].

Figure 1

Dimensions in Nanomedicine

Nanodiagnostics

It is the use of nanodevices for the early disease identification or predisposition at cellular and molecular level. In in-vitro diagnostics, nanomedicine could increase the efficiency and reliability of the diagnostics using human fluids or tissues samples by using selective nanodevices, to make multiple analyses at subcellular scale, etc. In in vivo diagnostics, nanomedicine could develop devices able to work inside the human body in order to identify the early presence of a disease, to identify and quantify toxic molecules, tumor cells.

Regenerative medicine

It is an emerging multidisciplinary field to look for the reparation, improvement, and maintenance of cells, tissues, and organs by applying cell therapy and tissue engineering methods. With the help of nanotechnology it is possible to interact with cell components, to manipulate the cell proliferation and differentiation, and the production and organization of extracellular matrices.

Present day nanomedicine exploits carefully structured nanoparticles such as dendrimers, carbon fullerenes (buckyballs), and nanoshells to target specific tissues and organs. These nanoparticles may serve as diagnostic and therapeutic antiviral, antitumor, or anticancer agents. Years ahead, complex nanodevices and even nanorobots will be fabricated, first of biological materials but later using more durable materials such as diamond to achieve the most powerful results.[6]

The human body is comprised of molecules, hence the availablity of molecular nanotechnology will permit dramatic progress to address medical problems and will use molecular knowledge to maintain and improve human health at the molecular scale.

Applications in medicine

Within 10–20 years it should become possible to construct machines on the micrometer scale made up of parts on the nanometer scale. Subassemblies of such devices may include such as useful robotic components as 100 nm manipulater arms, 10 nm sorting rotors for molecule by molecule reagent purification, and smooth super hard surfaces made of automically flawless diamond.

Nanocomputers would assume the important task of activating, controlling, and deactivating such nanomechanical devices. Nanocomputers would store and execute mission plans, receive and process external signals and stimuli, communicate with other nanocomputers or external control and monitoring devices, and possess contextual knowledge to ensure safe functioning of the nanomechanical devices. Such technology has enormous medical and dental implications.

Programmable nanorobotic devices would allow physicians to perform precise interventions at the cellular and molecular level. Medical nanorobots have been proposed for genotological[7] applicatons in pharmaceuticals research,[8] clinical diagnosis, and in dentistry,[9] and also mechanically reversing atherosclerosis, improving respiratory capacity, enabling near-instantaneous homeostasis, supplementing immune system, rewriting or replacing DNA sequences in cells, repairing brain damage, and resolving gross cellular insults whether caused by irreversible process or by cryogenic storage of biological tissues.

Feynman offered the first known proposal for a nanorobotic surgical procedure to cure heart disease,[2] “A friend of mine (Albert R. Hibbs) suggests a very interesting possibility for relatively small machines. He says that, although it is a very wild idea, it would be interesting in surgery if you could swallow the surgeon. You put the mechanical surgeon inside the blood vessel and it goes into the heart and looks around. It finds out which valve is the faulty and takes a little knife and slices it out, that we can manufacture an object that maneuvers at that level, other small machines might be permanently incorporated in the body to assist some inadequately functioning organs”.[2]

Many disease causing culprits such as bacteria and viruses are nanosize. So, it only makes sense that nanotechnology would offer us ways of fighting back. The ancient greeks used silver to promote healing and prevent infection, but the treatment took backseat when antibiotics came on the scene. Nycryst pharmaceuticals (Canada) revived and improved an old cure by coating a burn and wound bandage with nanosize silver particles that are more reactive than the bulk form of metal. They penetrate into skin and work steadily. As a result, burn victims can have their dressings changed just once a week.

Genomics and protomics research is already rapidly elucidating the molecular basis of many diseases. This has brought new opportunities to develop powerful diagnostic tools able to identify genetic predisposition to diseases. In the future, point of care diagnosis will be routinely used to identify those patients requiring preventive medication to select the most appropriate medication for individual patients, and to monitor response to treatment. Nanotechnology has a vital role to play in realizing cost-effective diagnostic tools.

Chris Backous developing Lab–on-Chip to give doctor immediate results from medical tests for cancer and viruses, it gets its information by analyzing the genetic material in individual cells. Advances in gene sequencing mean this can now be done quickly and sequencing with tiny samples of body fluids or tissues such as blood, bone marrow, or tumors. The device can also detect the BK virus, a sign of trouble in patients who have had kidney transplants. Ultimately (Pilarski thinks,) chip technology will be able to detect what kind of flu a person has, or, even if they have SARS or HIV.

Nanotechnology has the potential to offer invaluable advances such as use of nanocoatings to slow the release of asthma medication in the lungs, allowing people with asthma to experience longer periods of relief from symptoms after using inhalants. Thus, what nanotechnology tries to do is essentially make drug particles in such a way, that they don’t dissolve that fast, done this with.

Nanosensors developed for military use in recognizing airborne rogue agents and chemical weapons to detect drugs and other substances in exhaled breath.[1] Basically, you can detect many drugs in breath, but the amount you detect in breath is going to be related to the amount that you take and also to whether it partitions well between the blood and the breath. Drug abuse like marijuna (and things like), concentration of alcohol, testing of athletes for banned substances, and individual’s drug treatment programs are two areas long overdue for breath detection technologies. We see this in future totally replacing urine testing.

Currently, most legal and illegal drug overdoses have no specific way to be effectively neutralized, using nanoparticles as absorbents of toxic drugs, is another area of medical nanoscience that is rapidly gaining momentum. Goal is design nanostructures that effectively bind molecular entities, which currently don’t have effective treatments. We are putting nanosponges into the blood stream and they are soaking up toxic drug molecules to reduce the free amount in the blood, in turn, causes a resolution of the toxicity that was there before you put the nanosponges into the blood.

French and Italian researchers have come up with a completely new approach to render anticancer and antiviral nucleoside analoges significantly more potent. By linking the nucleoside analoges to sequalene, a biochemical precursor to the whole family of steroids, the researchers observed the self-organization of amphiphilic molecules in water. These nanoassemblies exhibited superior anticancer activity in vitro in human cancer cells.

Laurie B Gower, PhD, has been researching bone formation and structure at the nanoscale level. She is examining biomimetic methods of constructing a synthetic bone graft substitute with a nanostructured architecture that matches natural bone so that it would be accepted by the body and guide the cells toward the mending of damaged bones. Biomineralization refers to minerals that are formed biologically, which have very different properties than geological minerals or lab-formed crystals. The crystal properties found in bone are manipulated at nanoscale and are imbedded within collagen fibers to create an interpenetrating organic–inorganic composite with unique mechanical properties. She foresees numerous implications of the material in the future of osteology.

Hichan Fenniri, a chemistry professor, tried to make artificial joints act more like natural ones. Fenniri has made a nanotube coating for titanium hip or knee, is very good mimic of collagen, as a result of coating attracts and attaches more bone cells, osteoblasts, which help in bone growth quickly than uncoated hip or knee.

There is ongoing attempts to build ‘medical microrobots’ for in vivo medical use.[10] In 2002, Ishiyama et al,[11] at Tohku University developed tiny magnetically driven spinning screws intended to swim along veins and carry drugs to infected tissues or even to burrow into tumors and kill them with heat. In 2005, Brad Nelson’s[12] team reported the fabrication of a microscopic robot, small enough (approximately 200 µm) to be injected into the body through a syringe. They hope that this device or its descendants might someday be used to deliver drugs or perform minimally invasive eye surgery. Gorden’s[9,13] group at the University of Manitoba has also proposed magnetically controlled ‘cytobots’ and ‘karyobots’ for performing wireless intracellular and intranuclear surgery.

‘Respirocytes’, the first theoreotical design study of a complete medical nanorobot ever published in peer-reviewed journal described a hypothetical artificial mechanical red blood cell or ‘respirocyte’ made of 18 billion precisely arranged structural atoms.[10,14] The respirocyte is a bloodborne spherical 1 µm diamondedoid 1000 atmosphere pressure vessel with reversible molecule selective surface pumps powered by endogenous serum glucose. This nanorobot would deliver 236 times more oxygen to body tissues per unit volume than natural red cells and would manage carbonic acidity, controlled by gas concentration sensors and an onboard nanocomputer.

Nanorobotic microbivores

Artificial phagocytes called microbivores could patrol the bloodstream, seeking out and digesting unwanted pathogens including bacteria, viruses, or fungi.[10,15] Microbivores would achieve complete clearance of even the most severe septicemic infections in hours or less. The nanorobots do not increase the risk of sepsis or septic shock because the pathogens are completely digested into harmless sugars, amino acids, and the like, which are the only effluents from the nanorobot.

Surgical nanorobotics

A surgical nanorobot, programmed or guided by a human surgeon, could act as a semiautonomous on site surgeon inside the human body, when introduced into the body through vascular system or cavities. Such a device could perform various functions such as searching for pathology and then diagnosing and correcting lesions by nanomanipulation, coordinated by an onboard computer while maintaining contact with the supervising surgeon via coded ultrasound signals.[10]

The earliest forms of cellular nanosurgery are already being explored today. For example, rapidly vibrating (100 Hz) micropipette with a <1 µm tip diameter has been used to completely cut dentrites from single neurons without damaging cell viability.[16] Axotomy of roundworm neurons was performed by femtosecond laser surgery, after which the axons functionally regenerated.[17] Femtolaser acts like a pair of nanoscissors by vaporizing tissue locally while leaving adjacent tissue unharmed. Femtolaser surgery has performed the individual chromosomes.[18]

Nanogenerators’

They could make new class of self-powered implantable medical devices, sensors, and portable electronics, by converting mechanical energy from body movement, muscle stretching, or water flow into electricity.

Nanogenerators produce electric current by bending and then releasing zinc oxide nanowires, which are both piezoelectric and semiconducting. Nanowires can be grown on polymer-based films, use of flexible polymer substrates could one day allow portable devices to be powered by movement of their users.

“Our bodies are good at converting chemical energy from glucose into the mechanical energy of our muscles,” Wang (faculty at Peking University and National Center for Nanoscience and Technology of China) explained “these nanogenerators can take mechanical energy and convert it to electrical energy for powering devices inside the body. This could open up tremendous possibilities for self-powered implantable medical devices.”

Nanodentistry

Nanodentistry will make possible the maintenance of comprehensive oral health by employing nanomaterials, biotechnology, including tissue engineering, and ultimately, dental nanorobotics. New potential treatment opportunities in dentistry may include, local anesthesia, dentition renaturalization, permanent hypersensitivity cure, complete orthodontic realignments during a single office visit, covalently bonded diamondised enamel, and continuous oral health maintenance using mechanical dentifrobots.

When the first micro-size dental nanorobots can be constructed, dental nanorobots might use specific motility mechanisms to crawl or swim through human tissue with navigational precision, acquire energy, sense, and manipulate their surroundings, achieve safe cytopenetration and use any of the multitude techniques to monitor, interrupt, or alter nerve impulse traffic in individual nerve cells in real time.

These nanorobot functions may be controlled by an onboard nanocomputer that executes preprogrammed instructions in response to local sensor stimuli. Alternatively, the dentist may issue strategic instructions by transmitting orders directly to in vivo nanorobots via acoustic signals or other means.

Inducing anesthesia

One of the most common procedure in dental practice, to make oral anesthesia, dental professionals will instill a colloidal suspension containing millions of active analgesic micron-sized dental nanorobot ‘particles’ on the patient’s gingivae. After contacting the surface of the crown or mucosa, the ambulating nanorobots reach the dentin by migrating into the gingival sulcus and passing painlessly through the lamina propria or the 1–3-micron thick layer of loose tissue at the cementodentinal junction. On reaching dentin, the nanorobots enter dentinal tubules holes that are 1–4 microns in diameter and proceed toward the pulp, guided by a combination of chemical gradients, temperature differentials, and even positional navigation, all under the control of the onboard nanocomputer as directed by the dentist.[9]

There are many pathways to choose from, near to CEJ, midway between junction and pulp, and near to pulp. Tubules diameter increases as it nears the pulp, which may facilitate nanorobot movement, although circumpulpal tubule openings vary in numbers and size (tubules number density 22,000 mm DEJ, 37,000 mm square midway, ans 48000 mm square near to pulp). Tubules branching patterns, between primary and irregular secondary dentin, regular secondary dentin in young and old teeth (sclerosing) may present a significant challenge to navigation.

The presence of natural cells that are constantly in motion around and inside the teeth including human gingival and pulpal fibroblasts, cementoblasts of the CDJ, bacteria inside dentinal tubules, odontoblasts near the pulp dentin border, and lymphocytes within the pulp or lamina propria suggested that such journey should be feasible by cell-sized nanorobots of similar mobility.

Once installed in the pulp and having established control over nerve impulse traffic, the analgesic dental nanorobots may be commanded by the dentist to shut down all sensitivity in any particular tooth that requires treatment. When on the hand-held controller display, the selected tooth immediately becomes numb. After the oral procedures completed, the dentist orders the nanorobots to restore all sensation, to relinguish control of nerve traffic and to engress, followed by aspiration. Nanorobotic analgesics offer greater patient comfort and reduced anxiety, no needles, greater selectivity, and controllability of the analgesic effect, fast and completely reversible switchable action and avoidance of most side effects and complications.

Tooth repair

Nanorobotic manufacture and installation of a biologically autologous whole replacement tooth that includes both mineral and cellular components, that is, ‘complete dentition replacement therapy’ should become feasible within the time and economic constraints of a typical office visit through the use of an affordable desktop manufacturing facility, which would fabricate the new tooth in the dentist’s office.

Chen et al[19] took advantage of these latest developments in the area of nanotechnology to simulate the natural biomineralization process to create the hardest tissue in the human body, dental enamel, by using highly organized microarchitectural units of nanorod-like calcium hydroxyapatite crystals arranged roughly parallel to each other.

Dentin hypersensitivity

Natural hypersensitive teeth have eight times higher surface density of dentinal tubules and diameter with twice as large than nonsensitive teeth. Reconstructive dental nanorobots, using native biological materials, could selectively and precisely occlude specific tubules within minutes, offering patients a quick and permanent cure.[9]

Tooth repositioning

Orthodontic nanorobots could directly manipulate the periodontal tissues, allowing rapid and painless tooth straightening, rotating and vertical repositioning within minutes to hours.

Tooth renaturalization

This procedure may become popular, providing perfect treatment methods for esthetic dentistry. This trend may begin with patients who desire to have their (1) old dental amalgams excavated and their teeth remanufactured with native biological materials, and (2) full coronal renaturalization procedures in which all fillings, crowns, and other 20th century modifications to the visible dentition are removed with the affected teeth remanufactured to become indistinguishable from original teeth.

Dental durability and cosmetics

Durability and appearance of tooth may be improved by replacing upper enamel layers with covalently bonded artificial materials such as sapphire or diamond,[20] which have 20–100 times the hardness and failure strength of natural enamel or contemporary ceramic veneers and good biocompatibility. Pure sapphire and diamond are brittle and prone to fracture, can be made more fracture resistant as part of a nanostructured composite material that possibly includes embedded carbon nanotubes.

Nanorobotic dentifrice (dentifrobots) delivered by mouthwash or toothpaste could patrol all supragingival and subgingival surfaces at least once a day metabolizing trapped organic mater into harmless and odorless vapors and performing continous calculus debridement.

Properly configured dentifrobots could identify and destroy pathogenic bacteria residing in the plaque and elsewhere, while allowing the 500 species of harmless oral microflora to flourish in a healthy ecosystem. Dentifrobots also would provide a continous barriers to halitosis, since bacterial putrification is the central metabolic process involved in oral malodor. With this kind of daily dental care available from an early age, conventional tooth decay and gingival deseases will disappear into the annals of medical history.

Potential benefits of nanotechnology are its ability to exploit the atomic or molecular properties of materials and the development of newer materials with better properties. Nanoproducts can be made by: building-up particles by combining atomic elements and using equipments to create mechanical nanoscale objects.

Nanotechnology has improved the properties of various kinds of fibers.[21] Polymer nanofibers with diameters in the nanometer range, possess a larger surface area per unit mass and permit an easier addition of surface functionalities compared to polymer microfibers.[21,22] Polymer nanofiber materials have been studied as drug delivery systems, scaffolds for tissue engineering and filters. Carbon fibers with nanometer diamensions showed a selective increase in osteoblast adhesion necessary for successful orthopedic/dental implant applications due to a high degree of nanometer surface roughness.[23]

Nonagglomerated discrete nanoparticles are homogenously manufactured in resins or coatings to produce nanocomposites. The nanofiller used include an aluminosilicate powder having a mean particles size of about 80 nm and 1:4 M ratio of alumina to silica. Advantages – superior hardness, flexible strength, modulus of elasticity, translucency and esthetic appeal, excellent color density, high polish, and polish retention, and excellent handling properties.[24] (Filtek O supreme Univrasl Restorative Pure Nano O).

Heliometer, microfilled composite resin, a close examination of this composite suggests that a form of nanotechnology was in use years ago, yet never recognized.

Nanosolutions produce unique and dispersible nanoparticles that can be added to various solvents, paints, and polymers in which they are dispersed homogenously. Nanotechnology in bonding agents ensures homogeneity and so the operator can now be totally confident that the adhesive is perfectly mixed every time.

Nanofillers are integrated in the vinylsiloxanes, producing a unique addition siloxane impression material. Better flow, improved hydrophilic properties, hence fewer voids at margin and better model pouring, enhanced detail precision.[25]

DISCUSSION

Nanotechnology is part of a predicted future in which dentistry and periodontal practice may become more high-tech and more effective looking to manage individual dental health on a microscopic level by enabling us to battle decay where it begins with bacteria. Construction of a comprehensive research facility is crucial to meet the rigorous requirements for the development of nanotechnologies.

Researchers are looking at ways to use microscopic entities to perform tasks that are now done by hand or with equipment. This concept is known as nanotechnology. Tiny machines, known as nanoassemblers, could be controlled by computer to perform specialized jobs. The nanoassemblers could be smaller than a cell nucleus so that they could fit into places that are hard to reach by hand or with other technology. Used to destroy bacteria in the mouth that cause dental caries or even repair spots on the teeth where decay has set in, by use of computer to direct these tiny workers in their tasks.

Nanotechnology has tremendous potential, but social issues of public acceptance, ethics, regulation, and human safety must be addressed before molecular nanotechnology can be seen as the possibility of providing high quality dental care to the 80% of the world’s population that currently receives no significant dental care.

Role of periodontitis will continue to evolve along the lines of currently visible trends. For example, simple self-care neglect will become fewer, while cases involving cosmetic procedures, acute trauma, or rare disease conditions will become relatively more commonplace.

Trends in oral health and disease also may change the focus on specific diagnostic and treatment modalities. Increasingly preventive approaches will reduce the need for cure prevention a viable approach for the most of them.

Diagnosis and treatment will be customized to match the preferences and genetics of each patient. Treatment options will become more numerous and exciting. All this will demand, even more so than today, the best technical abilities, professional skills that are the hallmark of the contemporary dentist and periodontist. Developments are expected to accelerate significantly.

Nanometers and nanotubes, technologies could be used to administer drugs more precisely. Technology should be able to target specific cells in a patient suffering from cancer or other life-threatening conditions. Toxic drugs used to fight these illnessess would become much more direct and consequently less harmful to the body.

CONCLUSION

The visions described in this article may sound unlikely, implausible, or even heretic. Yet, the theoretical and applied research to turn them into reality is progressing rapidly. Nanotechnology will change dentistry, healthcare, and human life more profoundly than many developments of the past. As with all technologies, nanotechnology carries a significant potential for misuse and abuse on a scale and scope never seen before. However, they also have potential to bring about significant benefits, such as improved health, better use of natural resources, and reduced environmental pollution. These truly are the days of miracle and wonder.

Current work is focused on the recent developments, particularly of nanoparticles and nanotubes for periodontal management, the materials developed from such as the hollow nanospheres, core shell structures, nanocomposites, nanoporous materials, and nanomembranes will play a growing role in materials development for the dental industry.

Once nanomechanics are available, the ultimate dream of every healer, medicine man and physician throughout recorded history will, at last become a reality. Programmable and controllable microscale robots comprised of nanoscale parts fabricated to nanometer precision will allow medical doctors to execute curative and reconstructive procedures in the human body at the cellular and molecular levels. Nanomedical physicians of the 21st century will still make good use of the body’s natural healing powers and homeostatic mechanisms, because all else equal, those interventions are best that intervene least.

Footnotes

Source of Support: Nil

Conflict of Interest: None declared.

REFERENCES

  1. Rocco Castoro. U F expects big things from the science of small, nanotechnology. Think Small. The POST 02-2005.
  2. Feynman RP. There’s plenty of room at the bottom. Eng Sci. 1960;23:22–36.
  3. Drexler KE. New era of nanotechnology. New York: Anchor Press; 1986. Engines of creation: The coming era of nanotechnology; pp. 99–129.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2813556/?report=reader

The MIT-Harvard Center for Cancer Nanotechnology Excellence is a collaborative effort among MIT, Harvard University, Harvard Medical School, Massachusetts General Hospital, and Brigham and Women’s Hospital. It is one of eight Centers of Cancer Nanotechnology Excellence awarded by The National Cancer Institute (NCI), part of the National Institutes of Health (NIH). It focuses on developing a diversified portfolio of nanoscale devices for targeted delivery of cancer therapies, diagnostics, non-invasive imaging, and molecular sensing. In addition to general oncology applications, the Consortium focuses on prostate, brain, lung, ovarian, and colon cancer.

Examples of projects that the Consortium is undertaking include the development of:

  • Targeted nanoparticles for treating prostate cancer
  • Polymer nanoparticles and quantum dots for siRNA delivery
  • Next-generation magnetic nanoparticles for multimodal, non-invasive tumor imaging
  • Implantable, biodegradable microelectromechanical systems (MEMS), also known as lab-on-a-chip devices, for in vivo molecular sensing of tumor-associated biomolecules
  • Low-toxicity nanocrystal quantum dots for biomedical sensing

In addition to drawing on the scientific and technological expertise of its investigators, the Consortium uses available facilities for toxicology testing and the extensive mouse models of cancer collection at the collaborating institutions.

  1.  Nanotechnology and CancerNanotechnology is one of the most popular areas of scientific research, especially with regard to medical applications. We’ve already discussed some of the new detection methods that should bring about cheaper, faster and less invasive cancer diagnoses. But once the diagnosis occurs, there’s still the prospect of surgery, chemotherapy or radiation treatment to destroy the cancer. Unfortunately, these treatments can carry serious side effects. Chemotherapy can cause a variety of ailments, including hair loss, digestive problems, nausea, lack of energy and mouth ulcers.But nanotechnologists think they have an answer for treatment as well, and it comes in the form o ftargeted drug therapies. If scientists can load their cancer-detecting gold nanoparticles with anticancer drugs, they could attack the cancer exactly where it lives. Such a treatment means fewer side effects and less medication used. Nanoparticles also carry the potential for targeted and time-release drugs. A potent dose of drugs could be delivered to a specific area but engineered to release over a planned period to ensure maximum effectiveness and the patient’s safety.These treatments aim to take advantage of the power of nanotechnology and the voracious tendencies of cancer cells, which feast on everything in sight, including drug-laden nanoparticles. One experiment of this type used modified bacteria cells that were 20 percent the size of normal cells. These cells were equipped with antibodies that latched onto cancer cells before releasing the anticancer drugs they contained.Another used nanoparticles as a companion to other treatments. These particles were sucked up by cancer cells and the cells were then heated with a magnetic field to weaken them. The weakened cancer cells were then much more susceptible to chemotherapy.It may sound odd, but the dye in your blue jeans or your ballpoint pen has also been paired with gold nanoparticles to fight cancer. This dye, known as phthalocyanine, reacts with light. The nanoparticles take the dye directly to cancer cells while normal cells reject the dye. Once the particles are inside, scientists “activate” them with light to destroy the cancer. Similar therapies have existed to treat skin cancers with light-activated dye, but scientists are now working to use nanoparticles and dye to treat tumors deep in the body.From manufacturing to medicine to many types of scientific research, nanoparticles are now rather common, but some scientists have voiced concerns about their negative health effects. Nanoparticles’ small size allows them to infiltrate almost anywhere. That’s great for cancer treatment but potentially harmful to healthy cells and DNA. There are also questions about how to dispose of nanoparticles used in manufacturing or other processes. Special disposal techniques are needed to prevent harmful particles from ending up in the water supply or in the general environment, where they’d be impossible to track.Gold nanoparticles are a popular choice for medical research, diagnostic testing and cancer treatment, but there are numerous types of nanoparticles in use and in development. Bill Hammack, a professor of chemical engineering at the University of Illinois, warned that nanoparticles are “technologically sweet” [Source: Marketplace]. In other words, scientists are so wrapped up in what they can do, they’re not asking if they should do it. The Food and Drug Administration has a task force on nanotechnology, but as of yet, the government has exerted little oversight or regulation.
  2. The U.S. Food and Drug Administration (FDA)regulates a wide range of products, including foods, cosmetics, drugs, devices, veterinary products, and tobacco products some of which may utilize nanotechnology or contain nanomaterials. Nanotechnology allows scientists to create, explore, and manipulate materials measured in nanometers (billionths of a meter).  Such materials can have chemical, physical, and biological properties that differ from those of their larger counterparts.Guidance documents issued
    • On June 24, 2014, FDA issued three final guidance documentsrelated to the use of nanotechnology in regulated products,incuding cosmetics and food substances.
    • On August 5, 2015, FDA issued one final guidance documentrelated to the use of nanotechnology in food for animals.
      • FDA Guidance on Nanotechnology
        1. Nanotechnology Fact Sheet
        2. FDA issues three final guidances related to nanotechnology applications in regulated products, including cosmetics and food substances (June 2014)
        3. FDA issues final guidance on the use of nanotechnology in food for animals (August 2015)
        4. Nanotechnology in TherapeuticsA Focus on Nanoparticles as a Drug Delivery SystemSuwussa Bamrungsap; Zilong Zhao; Tao Chen; Lin Wang; Chunmei Li; Ting Fu; Weihong TanDisclosuresNanomedicine. 2012;7(8):1253-1271.AbstractContinuing improvement in the pharmacological and therapeutic properties of drugs is driving the revolution in novel drug delivery systems. In fact, a wide spectrum of therapeutic nanocarriers has been extensively investigated to address this emerging need. Accordingly, this article will review recent developments in the use of nanoparticles as drug delivery systems to treat a wide variety of diseases. Finally, we will introduce challenges and future nanotechnology strategies to overcome limitations in this field.IntroductionNanotechnology involves the engineering of functional systems at the molecular scale. Such systems are characterized by unique physical, optical and electronic features that are attractive for disciplines ranging from materials science to biomedicine. One of the most active research areas of nanotechnology is nanomedicine, which applies nanotechnology to highly specific medical interventions for the prevention, diagnosis and treatment of diseases.[1,2,401] The surge in nanomedicine research during the past few decades is now translating into considerable commercialization efforts around the globe, with many products on the market and a growing number in the pipeline. Currently, nanomedicine is dominated by drug delivery systems, accounting for more than 75% of total sales.[3]

          Nanomaterials fall into a size range similar to proteins and other macromolecular structures found inside living cells. As such, nanomaterials are poised to take advantage of existing cellular machinery to facilitate the delivery of drugs. Nanoparticles (NPs) containing encapsulated, dispersed, absorbed or conjugated drugs have unique characteristics that can lead to enhanced performance in a variety of dosage forms. When formulated correctly, drug particles are resistant to settling and can have higher saturation solubility, rapid dissolution and enhanced adhesion to biological surfaces, thereby providing rapid onset of therapeutic action and improved bioavailability. In addition, the vast majority of molecules in a nanostructure reside at the particle surface,[4] which maximizes the loading and delivery of cargos, such as therapeutic drugs, proteins and polynucleotides, to targeted cells and tissues. Highly efficient drug delivery, based on nanomaterials, could potentially reduce the drug dose needed to achieve therapeutic benefit, which, in turn, would lower the cost and/or reduce the side effects associated with particular drugs. Furthermore, NP size and surface characteristics can be easily manipulated to achieve both passive and active drug targeting. Site-specific targeting can be achieved by attaching targeting ligands, such as antibodies or aptamers, to the surface of particles, or by using guidance in the form of magnetic NPs. NPs can also control and sustain release of a drug during transport to, or at, the site of localization, altering drug distribution and subsequent clearance of the drug in order to improve therapeutic efficacy and reduce side effects.

          Nanotechnology could be strategically implemented in new developing drug delivery systems that can expand drug markets. Such a plan would be applied to drugs selected for full-scale development based on their safety and efficacy data, but which fail to reach clinical development because of poor biopharmacological properties, for example, poor solubility or poor permeability across the intestinal epithelium, situations that translate into poor bioavailability and undesirable pharmacokinetic properties.[5] The new drug delivery methods are expected to enable pharmaceutical companies to reformulate existing drugs on the market, thereby extending the lifetime of products and enhancing the performance of drugs by increasing effectiveness, safety and patient adherence, and ultimately reducing healthcare costs.[6–8]

          Commercialization of nanotechnology in pharmaceutical and medical science has made great progress. Taking the USA alone as an example, at least 15 new pharmaceuticals approved since 1990 have utilized nanotechnology in their design and drug delivery systems. In each case, both product development and safety data reviews were conducted on a case-by-case basis, using the best available methods and procedures, with an understanding that postmarketing vigilance for safety issues would be ongoing. Some representative examples of therapeutic nanocarriers on the market are briefly described in Table 1.

          In this review, we focus mainly on the application of nanotechnology to drug delivery and highlight several areas of opportunity where current and emerging nanotechnologies could enable novel classes of therapeutics. We look at challenges and general trends in pharmaceutical nanotechnology, and we also explore nanotechnology strategies to overcome limitations in drug delivery. However, this article can only serve to provide a glimpse into this rapidly evolving field, both now and what may be expected in the future.

          Nanocarriers & Their Applications

          Various nanoforms have been attempted as drug delivery systems, varying from biological substances, such as albumin, gelatin and phospholipids for liposomes, to chemical substances, such as various polymers and solid metal-containing NPs (Figure 1). Polymer–drug conjugates, which have high size variation, are normally not considered as NPs. However, since their size can still be controlled within 100 nm, they are also included in these nanodelivery systems. These nanodelivery systems can be designed to have drugs absorbed or conjugated onto the particle surface, encapsulated inside the polymer/lipid or dissolved within the particle matrix. As a consequence, drugs can be protected from a critical environment or their unfavorable biopharmaceutical properties can be masked and replaced with the properties of nanomaterials. In addition, nanocarriers can be accumulated preferentially at tumor, inflammatory and infectious sites by virtue of the enhanced permeability and retention (EPR) effect. The EPR effect involves site-specific characteristics, not associated with normal tissues or organs, thus resulting in increased selective targeting. Based on those properties, nanodrug delivery systems offer many advantages,[9–11] including:

          (Enlarge Image)

          Figure 1.

          Some nanotechnology-based drug delivery platforms, including a nanocrystal, liposome, polymeric micelle, protein-based nanoparticle, dendrimer, carbon nanotube and polymer–drug conjugate.
          NP: Nanoparticle.

          • Improving the stability of hydrophobic drugs, rendering them suitable for administration;
          • Improving biodistribution and pharmacokinetics, resulting in improved efficacy;
          • Reducing adverse effects as a consequence of favored accumulation at target sites;
          • Decreasing toxicity by using biocompatible nanomaterials.

          By adopting nanotechnology, fundamental changes in drug production and delivery are expected to affect approximately half of the worldwide drug production in the next decade, totaling approximately US$380 billion in revenue.[12] Next, several main nanocarriers are briefly discussed.

          Nanocrystals

          One of the most obvious and important nanotechnology tools for product development is the opportunity to convert existing drugs with poor water solubility and dissolution rate into readily water-soluble dispersions by converting them into nanosized drugs.[13,14] In other words, the drug itself may be formulated at a nanoscale such that it can function as its own ‘carrier’.[15] Many approaches have been studied, but the most practical strategy involves reducing the drug particle size to nanometer range and stabilizing the drug NP surface with a layer of nonionic surfactants or polymeric macromolecules.[16] By reducing the particle size of the active pharmaceutical ingredient, the drug’s surface area is increased considerably, thereby improving its solubility and dissolution and consequently increasing both the maximum plasma concentration and area under the curve. Once the drug is nanosized, it can be formulated into various dosage forms, such as oral, nasal and injectable. These nanocrystal drugs may have advantages over association colloids (micelle solutions) because the level of surfactant per amount of drug can be greatly minimized, using only the amount that is necessary to stabilize the solid–fluid interface.[15]

          Furthermore, recent studies have shown that external agents, such as surfactants, for nanocrystal drug delivery can be eliminated. For example, a method was recently developed for the delivery of a hydrophobic photosensitizing anticancer drug in its pure form using nanocrystals.[17] Synthesized by the reprecipitation method, the resulting drug nanocrystals were stable in aqueous dispersion, without the necessity of any additional stabilizer. These nanocrystals are uniform in size distribution with an average diameter of 110 nm. Such nanocrystals were efficiently taken up by tumor cells in vitro, and irradiation of such cells with visible light (665 nm) resulted in significant cell death. An in vivo study of the nanocrystal drug also showed significant efficacy compared with the conventional surfactant-based delivery system. These results illustrate the potential of pure drug nanocrystals for photodynamic therapy. As shown in Table 1 , a number of well-known drugs have already been commercialized using the nanocrystal approach.

          Organic Nanoplatforms

          Liposomes Liposomes are self-assembled artificial vesicles developed from amphiphilic phospholipids. These vesicles consist of a spherical bilayer structure surrounding an aqueous core domain, and their size can vary from 50 nm to several micrometers. Liposomes have attractive biological properties, including general biocompatibility, biodegradability, isolation of drugs from the surrounding environment and the ability to entrap both hydrophilic and hydrophobic drugs. Through the addition of agents to the lipid membrane, or the alteration of the surface chemistry, liposome properties, such as size, surface charge and functionality, can be easily tuned.

          Liposomes are the most clinically established nanosystems for drug delivery. Their efficacy has been demonstrated in reducing systemic effects and toxicity, as well as in attenuating drug clearance.[18,19]Modified liposomes at the nanoscale have been shown to have excellent pharmacokinetic profiles for the delivery of DNA, antisense oligonucleotide, siRNA, proteins and chemotherapeutic agents.[20]Examples of marketed liposomal drugs with higher efficacy and lower toxicity than their nonliposomal analogues are listed in Table 1 . Doxorubicin is an anticancer drug that is widely used for the treatment of various types of tumors. It is a highly toxic compound affecting not only tumor tissue, but also heart and kidney, a fact that limits its therapeutic applications. However, the development of doxorubicin enclosed in liposomes culminated in an approved nanomedical drug delivery system.[21,22] This novel liposomal formulation has resulted in reduced delivery of doxorubicin to the heart and renal system, while elevating the accumulation in tumor tissue[23,24] by the EPR effect. Furthermore, a number of liposomal drugs are currently being investigated, including anticancer agents, such as camptothecin[25]and paclitaxel (PTX),[26] as well as antibiotics, such as vancomycin[27] and amikacin.[28]

          Liposomes are also subject to some limitations, including low encapsulation efficiency, fast burst release of drugs, poor storage stability and lack of tunable triggers for drug release.[29] Furthermore, since liposomes cannot usually permeate cells, drugs are released into the extracellular fluid.[30] As such, many efforts have focused on improving their stability and increasing circulation half-life for effective targeting or sustained drug action.[19,31] Surface modification is one method of conferring stability and structural integrity against a harsh bioenvironment after oral or parenteral administration.[32] Surface modification can be achieved by attaching polyethylene glycol (PEG) units, which form a protective layer over the liposome surface (known as stealth liposomes) to slow down liposome recognition, or by attaching other polymers, such as poly(methacrylic acid-co-cholesteryl methacrylate)[33] and poly(actylic acid),[34] to improve the circulation time of liposomes in blood. To overcome the fast burst release of the chemotherapeutic drugs from liposomes, drugs such as doxorubicin may be encapsulated in the liposomal aqueous phase by an ammonium sulphate gradient.[35] This strategy enables stable drug entrapment with negligible drug leakage during circulation, even after prolonged residence in the blood stream.[36] Further efforts to improve control over the rate of release and drug bioavailability have been made by designing liposomes whose release is environmentally triggered. Accordingly, the drug release from liposome-responsive polymers, or hydrogel, is triggered by a change in pH, temperature, radiofrequency or magnetic field.[37] Liposomes have also been conjugated with active-targeting ligands, such as antibodies[38–40] or folate, for target-specific drug delivery.[41]

          Polymeric NPs Polymeric NPs are colloidal particles with a size range of 10–1000 nm, and they can be spherical, branched or core–shell structures. They have been fabricated using biodegradable synthetic polymers, such as polylactide–polyglycolide copolymers, polyacrylates and polycaprolactones, or natural polymers, such as albumin, gelatin, alginate, collagen and chitosan.[42] Various methods, such as solvent evaporation, spontaneous emulsification, solvent diffusion, salting out/emulsification-diffusion, use of supercritical CO2 and polymerization, have been used to prepare the NPs.[43]Advances in polymer science and engineering have resulted in the development of smart polymer (stimuli-sensitive polymer), which can change its physicochemical properties in response to environmental signals. Physical (temperature, ultrasound, light, electricity and mechanical stress), chemical (pH and ionic strength) and biological signals (enzymes and biomolecules) have been used as triggering stimuli. Various monomers having sensitivity to specific stimuli can be tailored to a homopolymer in response to a certain signal or copolymers answering multiple stimuli. The versatility of polymer sources and their easy combination make it possible to tune up polymer sensitivity in response to a given stimulus within a narrow range, leading to more accurate and programmable drug delivery.

          Polymeric nanocarriers can be categorized based on three drug-incorporation mechanisms. The first includes polymeric carriers that use covalent chemistry for direct drug conjugation (e.g., linear polymers). The second group includes hydrophobic interactions between drugs and nanocarriers (e.g., polymeric micelles from amphiphilic block copolymers). Polymeric nanocarriers in the third group include hydrogels, which offer a water-filled depot for hydrophilic drug encapsulation.

          Polymer–Drug Conjugates (Prodrugs) Many polymer–drug conjugates have been developed since the first combination reported in the 1970s.[44,45] Conjugation of macromolecular polymers to drugs can significantly enhance the blood circulation time of the drugs. Especially, protein or peptide drugs, which can be readily digested inside the human body, can maintain their activity by conjugation of the water-soluble polymer PEG (PEGylation). For example, it was reported that PEGylated L-asparaginase increased its plasma half-life by up to 357 h.[46] Without PEG, the half-life of natural L-asparaginase is only 20 h. In addition to PEGylation of proteins, small molecular anticancer drugs can also be PEGylated to improve their pharmacokinetics for cancer therapy. For instance, PEG-camptothecin (PROTHECAN®) has entered clinical trials for cancer therapy.[47]

          Increasing the otherwise poor solubility of some drugs is another important function of polymer–drug conjugation. Specifically, conjugating water-soluble polymers to functional groups that already exist in the drug structure can significantly enhance the water solubility of the drug. Recently, a new category of polymer–drug conjugates called brush polymer–drug conjugates were prepared by ring-opening metathesis copolymerization.[48] In this report, as PEG was employed as the brush polymer side chains, the conjugates exhibited significant water solubility. However, polymer–drug conjugates require chemical modification of the existing drugs; as a consequence, their production could cost more, and additional purification steps are needed. Moreover, polymers that are chemically conjugated with drugs are often considered new chemical entities owing to a pharmacokinetic profile distinct from that of the parent drugs. As such, additional US FDA approval is required, even though the parent drug has already been approved. Despite the variety of novel drug targets and sophisticated chemistries available, only four drugs (doxorubicin, camptothecin, PTX and platinate) and four polymers (N-[2-hydroxylpropyl]methacrylamide [HPMA] copolymer, poly-L-glutamic acid [PGA], PEG and dextran) have been used to develop polymer–drug conjugates.[49–54] In addition to the commercially available polymer drugs listed in Table 1 , PGA-PTX (Xyotax™, CT-2103; Cell Therapeutics Inc./Chugai Pharmaceutical Co. Ltd.),[55] PGA-camptothecin (CT-2106; Cell Therapeutics Inc.)[56] and HPMA–doxorubicin (PK1/FCE-28068; Pfizer Inc./Cancer Research Campaign)[57] are now in clinical trials. As an example, PK1 has been evaluated in clinical trials as an anticancer agent, and a Phase I evaluation has been completed in patients with several types of tumors resistant to prior therapy, such as chemotherapy or radiation. However, although the clinical results for HPMA–doxorubicin conjugates look promising, PEG-based conjugation remains the gold-standard in the field of polymeric drug delivery. In addition, polymer–drug conjugates are still limited by their nonbiodegradability and the fate of polymers after in vivoadministration.[58]

          Polymeric Micelles Polymeric micelles are formed when amphiphilic surfactants or polymeric molecules spontaneously associate in aqueous medium to form core–shell structures. The inner core of a micelle, which is hydrophobic, is surrounded by a shell of hydrophilic polymers, such as PEG.[59] Their hydrophobic core serves as a reservoir for poorly water-soluble and amphiphilic drugs; at the same time, their hydrophilic shell stabilizes the core, prolongs circulation time in blood and increases accumulation in tumor tissues.[41] So far, a large variety of drug molecules have been incorporated into polymeric micelles, either by physical encapsulation[60,61] or covalent attachment.[62] Genexol-PM® (Samyang, Korea), PEG-poly(D,L-lactide)-PTX, employs cremophor-free polymeric micelles loaded with PTX drugs. It was found to have a three-times higher maximum tolerated dose in nude mice and two- to threefold higher levels of biodistribution, compared with those of pristine PTX, in various tissues, including tumors. A Phase I clinical trial has been evaluated in patients, and the results showed that Genexol-PM is superior to conventional PTX for the delivery of higher doses without additional toxicity.[63] Recently, a series of novel dual targeting micellar delivery systems were developed based on the self-assembled hyaluronic acid-octadecyl (HA-C18) copolymer and folic acid-conjugated HA-C18 (FA-HA-C18). PTX was successfully encapsulated by HA-C18 and FA-HA-C18 polymeric micelles, with a high encapsulation efficiency of 97.3%. Since these copolymers are biodegradable, biocompatible and cell-specifically targetable, they become promising nanostructure carriers for hydrophobic anticancer drugs.[64] In addition, stimuli-responsive drug-loaded micelles[65–69] and multifunctional polymeric micelles containing imaging as well as therapeutic agents[70–72] are now under active investigation with the potential to be the mainstream of the polymeric drug development in the near future. Furthermore, using computer simulation, the experimental preparation of drug-loaded polymeric micelles could be more efficiently guided, by providing insight into the mechanism of mesoscopic structures and serving as a complement to experiments.[73]

          Hydrogel NPs In recent years, hydrogel NPs have gained considerable attention as one of the most promising nanoparticulate drug delivery systems owing to their unique properties. Hydrogels are cross-linked networks of hydrophilic polymers that can absorb and retain more than 20% of their weight in water, while at the same time, maintaining the distinct 3D structure of the polymer network. Swelling properties, network structure, permeability or mechanical stability of hydrogels can be controlled by external stimuli or physiological parameters.[74–78] Hydrogels have been extensively studied for controlled release of therapeutics, stimuli-responsive release and applications in biological implants.[75,79–81] However, the hydration response to changes in stimuli in most hydrogel systems is too slow for therapeutic applications. To overcome this limitation, further development of hydrogel structures at the micro- and nano-scale is needed.[82] Recent reports showed some progress in micro- and nanogels of poly-N-isopropylacrylamide with ultrafast responses and attractive rheological properties.[83,84] Ding et al. demonstrated that cisplatin-loaded polyacrylic acid hydrogel NPs could be implanted and plastered on tumor tissue.[85] This hydrogel system exhibited superior efficacy in impeding tumor growth and prolonging lifespan in mice. The in vivo biodistribution assay also demonstrated that the hydrogel implant results in high concentration and retention of the drug. A multifunctional hybrid hydrogel was developed by combining the magnetic properties of NPs and the typical characteristics of the hydrogel. These hybrid hydrogels could be used to load a large number of drugs and transport them to the target site by the application of an external magnetic field.[86] To improve the specificity of the hydrogel drug delivery systems, core–shell nanogels were developed, which utilize aptamers as the recognition element and near-infrared light as a triggering stimulus for drug delivery. In this system, gold (Au)–silver nanorods, which possess intense absorption bands in the near-infrared range, were coated with DNA cross-linked polymeric shells, so that drugs can be rapidly and controllably released upon the near-infrared irradiation.[87] As the fate of hydrogel NPs after in vivo administration may be a concern for clinical applications, biodegradable hydrogel NPs with diameters of approximately 200 nm have been synthesized via inverse miniemulsion reversible addition–fragmentation chain-transfer polymerization of 2-(dimethylamino)ethyl methacrylate. A disulfide cross-linker was used to cross-link the NPs, so that the polymer network could be degraded to its constituent primary chains by exposure to a reductive environment. It is indicated that these biodegradable hydrogel NPs are currently being investigated for encapsulation and controlled release of siRNA.[88] Although hydrogel NPs-based drugs are not commercially available, they have high possibility to be further developed for drug delivery systems in the future, owing to their highly biocompatible and effective drug-loading properties.

          Protein-based NPs Hydrophobic drugs, such as taxanes, are highly active and widely used in a variety of solid tumor therapies. Both PTX and docetaxel, which are the commercially available taxanes for clinical treatments, are hydrophobic. Because of their solubility problems, they have been formulated as suspensions with nonionic surfactants, such as Cremophor EL® (BASF Corp.) for PTX and Tween-80 (ICI Americas, Inc.) for docetaxel. However, these surfactants are associated with hypersensitivity reaction and toxic side effects to tissues. To decrease toxicity, albumin conjugated with PTX has been formulated, yielding NPs approximately 130 nm in size and approved by the FDA for breast cancer treatment.[89–91] In addition to reduced toxicity, albumin–PTX has been found to bind with the albumin receptor (gp60) on endothelial cells, with further extravascular transport,[92–94] resulting in an increase in drug concentration at tumor sites without hypersensitivity reactions. The albumin–PTX complex is approved in 38 countries for the treatment of metastatic breast cancer. Furthermore, Abraxane® is currently in various stages of investigation for the treatment of other cancers, such as metastatic breast cancer, non-small-cell lung cancer, malignant melanoma, pancreatic and gastric cancer.

          Dendrimers Dendrimers are synthetic, branched macromolecules that form a tree-like structure. Unlike most linear polymers, the chemical composition and molecular weight of dendrimers can be precisely controlled; hence, it is relatively easy to predict their biocompatibility and pharmacokinetics.[95]Dendrimers are very uniform with extremely low polydispersities, and they are commonly created with dimensions incrementally grown in approximate nanometer steps from 1 to over 10 nm. Their globular structures and the presence of internal cavities enable drugs to be encapsulated within the macromolecule interior and are used to provide controlled release from the inner core.[96] Although the small size (up to 10 nm) of dendrimers limits extensive drug incorporation, their dendritic nature and branching allows drug loading onto the outside surface of the structure[97] via covalent binding or electrostatic interactions. Dendrimers can be synthesized by either divergent or convergent approaches. In the divergent approach, dendrimers are synthesized from the core and further built to other layers called generations. However, this method provides a low yield because the reactions that occur must be conducted on a single molecule processing a large number of equivalent reaction sites.[98] In addition, a large amount of reagents is required for the latter stages of synthesis, resulting in complication of purification. For the convergent method, synthesis begins at the periphery of the dendrimer molecules and stops at the core. In this approach, each synthesized generation can be subsequently purified.[98]

          Drug molecules associated with dendrimers can be utilized for cancer treatment,[99] the enhancement of drug solubility and permeability (dendrimer–drug conjugates)[100] and intracellular delivery.[101] Some drugs can be physically encapsulated inside the dendrimer network or form linkages (either covalently or noncovalently) on the dendrimer surface.[102] Furthermore, functionalization of the dendrimer surface with specific ligands can enhance potential targeting. For example, Myc et al. reported a polyamidoamine dendrimer conjugate containing FA as the targeting agent and methotroxate as the therapeutic agent.[103] Cytotoxicity and specificity were tested with both FA receptor-expressing and nonexpressing cells. Both in vitro and in vivo results showed that the dendrimer conjugate was preferentially cytotoxic to the target cells. The polyamido amine dendrimer conjugated with an anti-prostate specific membrane antigen antibody was also demonstrated.[104] The antibody–dendrimer conjugate specifically bound to anti-prostate specific membrane antigen-positive, but not negative, cell lines. However, dendrimer toxicity and immunogenicity are the main concerns when they are applied for drug delivery. Since the clinical experience with dendrimers has so far been limited, it is hard to tell whether the dendrimers are intrinsically ‘safe’ or ‘toxic’.

          Inorganic Platforms

          Au NPs Noble metal NPs, such as Au NPs, have emerged as a promising scaffold for drug and gene delivery in that they provide a useful complement to more traditional delivery vehicles. The combination of inertness and low toxicity,[105] easy synthesis, very large surface area, well-established surface functionalization (generally through thiol linkages) and tunable stability provide Au NPs with unique attributes to enable new delivery strategies. Moreover, excess loading of pharmaceuticals on NPs allows ‘drug reservoirs’ to accumulate for controlled and sustained release, thereby maintaining the drug level within the therapeutic window. An Au NP with 2-nm core diameter could, in principle, be conjugated with 100 molecules to available ligands (n = 108) in the monolayer.[106] Zubarev et al. have recently succeeded in coupling 70 PTX molecules, a chemotherapeutic drug, to an Au NP with a 2-nm core diameter.[107] Efficient release of these therapeutic agents could be triggered by internal (e.g., glutathione[108] or pH[109]) or external (e.g., light[110,111]) stimuli. In addition to serving as the carrier for drug delivery, Au NPs can also be imaged using contrast imaging techniques. Once the Au NPs are targeted to the diseased site, such as a tumor, hyperthermia treatment can be used for tumor destruction. For example, a recent study demonstrated that PEGylated Au NPs were employed for highly efficient drug delivery and in vivo photodynamic therapy of cancer.[112] Compared with conventional photodynamic therapy drug delivery in vivo, PEGylated Au NPs accelerated the silicon phthalocyanine 4 administration by approximately two orders of magnitude without side effects in treated mice. The key issue that needs to be addressed with Au NPs is the engineering of the particle surface for optimized properties, such as bioavailability and nonimmunogenicity.

          Superparamagnetic NPs Magnetic NPs have been proposed as drug carriers with a push towards clinical trials.[113] The superparamagnetic properties of iron (II) oxide particles can be used to guide microcapsules in place for delivery by external magnetic fields. Another advantage of using magnetic NPs is the ability to heat the particles after internalization, which is known as the hyperthermia effect. For example, Brazel et al. developed a grafted thermosensitive polymeric system by embedding FePt NPs in poly(N-isopropylacrylamide)-based hydrogels, which can be triggered to release the loaded drug by inducing an increase in temperature based on a magnetic thermal heating event.[114] The grafted hydrogel system is also shown to exhibit a desirable positive thermal response with an increased drug diffusion coefficient for temperatures higher than physiological temperature.[115]

          Besides being utilized for targeting and raising temperature, magnetic NPs can also affect the permeability of microcapsules by applying external oscillating magnetic fields and releasing encapsulated materials.[116] For example, ferromagnetic Au-coated cobalt NPs (3 nm in diameter) were incorporated into the polymer walls of microcapsules. Subsequently, application of external alternating magnetic fields of 100–300 Hz and 1200 Oe strength disturbed the capsule wall structures and dramatically increased their permeability to macromolecules. This work supports the hypothesis that magnetic NPs embedded in polyelectrolyte capsules can be used for the controlled release of substances by applying an external magnetic field.

          The main benefits of superparamagnetic NPs over classical cancer therapies are minimal invasiveness, accessibility of hidden tumors and minimal side effects. Conventional heating of a tissue by, for example, microwaves or laser light results in the destruction of healthy tissue surrounding the tumor. However, targeted paramagnetic particles provide a powerful strategy for localized heating of cancerous cells.

          Ceramic NPs Ceramic NPs are particles fabricated from inorganic compounds with porous characteristics, such as silica, alumina and titania.[117–119] Among these, silica NPs have attracted much research attention as a result of their biocompatibility and ease of synthesis, as well as surface modification.[120–122,301] Furthermore, the well-established silane chemistry facilitates the cross-linking of drugs to silica particles.[123,124] For example, recent breakthroughs in mesoporous silica NPs (MSNs) have brought new possibilities to this burgeoning area of research. MSNs contain hundreds of empty channels (mesopores) arranged in a 2D network of a honeycomb-like porous structure. In contrast to the low biocompatibility of other amorphous silica materials, recent studies have shown that MSNs exhibit superior biocompatibility at concentrations adequate for pharmacological applications.[125,126]Once the vehicle is localized in the cytoplasm, it is desirable to have effective control over the release of drug molecules in order to reach pharmacologically effective levels. The ability to selectively functionalize the external particle and/or the interior nanochannel surface of MSNs is advantageous in achieving this goal.[127,128] Different functional groups can be added by using this methodology, including, for example, functionalization with stimuli-responsive tethers that could be further attached to NPs (Au and iron [II] oxide). These NPs could work as gatekeepers and be removed by either intracellular or external triggers, such as changes in pH, reducing environment, enzymatic activity, light, electromagnetic field or ultrasound.[128] The surface of MSNs can be engineered with cell-specific moieties, such as organic molecules, peptides, aptamers and antibodies, to achieve cell type or tissue specificity. Moreover, optical and magnetic contrast agents can be introduced to develop multipurpose drug delivery systems.

          These strategies demonstrated that the application of target-specific MSN vehicles in vitro is promising; however, the application in vivo has not yet been reported. These particles are not biodegradable; consequently, there is a concern that they may accumulate in the human body and cause harmful effects.[117] For further in vivo applications, the biocompatibility, biodistribution, retention, degradation and clearance of MSNs must be systematically investigated.

          Carbon-based Nanomaterials Carbon-based nanomaterials have attracted particular interest because they can be surface functionalized for the grafting of nucleic acids, peptides and proteins. Carbon nanotubes (CNTs), fullerene, and nanodiamonds[129] have been extensively studied for drug delivery applications.[130] The size, geometry and surface characteristics of single-wall nanotubes (SWNTs), multiwall nanotubes and C60 fullerenes make them appealing for drug carrier usage. For example, PTX-conjugated SWNTs have shown promise for in vivo cancer treatment. SWNT delivery of PTX affords markedly improved treatment efficacy over clinical Taxol (Bristol-Myers Squibb Co.), as evidenced by its ability to slow down tumor growth at a low PTX dose.[131]

          However, the primary drawback of carbon-based nanomaterials appears to be their toxicity. Experiments have shown that CNTs can lead to cell proliferation inhibition and apoptosis. Although they are less toxic than carbon fibers and NPs, the toxicity of CNTs increases significantly when carbonyl, carboxyl and/or hydroxyl functional groups are present on their surface.[132] Because of the reported toxicity of CNTs,[133–137] studies involving their application for drug delivery are still being conducted.[138–140] In order to promote the application of CNTs for drug delivery, researchers have functionalized their surface, rendering them benign.[136] Unfortunately, concerns that functionalized CNTs may revert back to a toxic state if the functional group detaches has limited the pursuit of using these modified CNTs for biomedical applications.

          The toxicity of other forms of nanocarbons has also been reported.[132,140,141] One study of human lung tumor cells showed that carbon NPs are even more toxic than multiwall nanotubes and carbon nanofibers.[132] Given the mounting evidence demonstrating the toxicity of carbon NPs, the enthusiasm to develop carbon NPs for drug delivery has decreased significantly in recent years.

          Integrated Nanocomposite Particles

          A variety of nanoplatforms have been developed for a wide spectrum of applications, and each of these applications has unique advantages and limitations. By combining the specific function of each material, new hybrid nanocomposite materials can be fabricated. For instance, liposomes and polymeric NPs are the two most widely studied drug delivery platforms, and attempts have been made to combine the advantages of both systems. A recent study reported the use of nanocells consisting of nuclear poly(lactic-co-glycolic acid) NPs within an extranuclear PEGylated phospholipid envelope for temporal targeting of tumor cells and neovasculature.[142] Moreover, liposomes are routinely coated with a hydrophilic polymer, such as PEG or poly(ethylene oxide), to improve the circulation time in vivo, which is another example of a liposome–polymer composite.[143] Similarly, liposomal locked-in dendrimers, the combination of liposomes and dendrimers in one formulation, has resulted in higher drug loading and slower drug release from the composite, as compared with pure liposomes.[144] Another LipoMag formulation, which consists of an oleic acid-coated magnetic nanocrystal core and a cationic lipid shell, was magnetically guided to deliver and silence genes in cells and tumors in mice.[145]

          Targeting Strategies

          Two basic requirements should be realized in the design of nanocarriers to achieve effective drug delivery (Figure 2). First, drugs should be able to reach the desired tumor sites after administration with minimal loss to their volume and activity in blood circulation. Second, drugs should only kill tumor cells without harmful effects to healthy tissue.[146] These requirements may be enabled using two strategies: passive and active targeting of drugs.[147]

          (Enlarge Image)

          Figure 2.

          Passive and active targeting.
          By the enhanced permeability and retention effect, nanoparticles (NPs) can be passively extravasated through leaky vascularization, allowing their accumulation at the tumor region (A). In this case, drugs may be released in the extracellular matrix and then diffuse through the tissue. Active targeting (B) can enhance the therapeutic efficacy of drugs by the increased accumulation and cellular uptake of NPs through receptor-mediated endocytosis. NPs can be engineered to incorporate ligands that bind to endothelial cell surface receptors. In this case, the enhanced permeability and retention effect does not pertain, and the presence of leaky vasculature is not required.

          Passive Targeting

          Passive targeting takes advantage of the unique pathophysiological characteristics of tumor vessels, enabling nanodrugs to accumulate in tumor tissues. Typically, tumor vessels are highly disorganized and dilated with a high number of pores, resulting in enlarged gap junctions between endothelial cells and compromised lymphatic drainage. The ‘leaky’ vascularization, which refers to the EPR effect, allows migration of macromolecules up to 400 nm in diameter into the surrounding tumor region.[147–149] One of the earliest nanoscale technologies for passive targeting of drugs was based on the use of liposomes. More advanced liposomes are coated with a synthetic polymer that protects the agents from immune destruction.[150]

          Moreover, the EPR effect, the microenvironment surrounding tumor tissue, is different from that of healthy cells, a physiological phenomenon that also supports passive targeting. Based on the high metabolic rate of fast-growing tumor cells, they require more oxygen and nutrients. Consequently, glycolysis is stimulated to obtain extra energy, resulting in an acidic environment.[151] Taking advantage of this, pH-sensitive liposomes have been designed to be stable at physiological pH 7.4, but degraded to release drug molecules at the acidic pH.[152]

          Although passive targeting approaches form the basis of clinical therapy, they suffer from several limitations. Ubiquitously targeting cells within a tumor is not always feasible because some drugs cannot diffuse efficiently, and the random nature of the approach makes it difficult to control the process. The passive strategy is further limited because certain tumors do not exhibit an EPR effect, and the permeability of vessels may not be the same throughout a single tumor.[153]

          Active Targeting

          One way to overcome the limitations of passive targeting is to attach affinity ligands (antibodies,[154]peptides,[155] aptamers[156] or small molecules[157] that only bind to specific receptors on the cell surface) to the surface of the nanocarriers by a variety of conjugation chemistries. Nanocarriers will recognize and bind to target cells through ligand–receptor interactions by the expression of receptors or epitopes on the cell surface. In order to achieve high specificity, those receptors should be highly expressed on tumor cells, but not on normal cells. Furthermore, the receptors should homogeneously express and should not be shed into the blood circulation. Internalization of targeting conjugates can also occur by receptor-mediated endocytosis after binding to target cells, facilitating drug release inside the cells. Based on the receptor-mediated endocytosis mechanism, targeting conjugates bind with their receptors first, followed by plasma membrane enclosure around the ligand–receptor complex to form an endosome. The newly formed endosome is transferred to specific organelles, and drugs could be released by acidic pH or enzymes. Although the active targeting strategy looks intriguing, nanodrugs currently approved for clinical use are relatively simple and generally lack active targeting or triggered drug release components. Moreover, nanodrugs currently under clinical development lack specific targeting. To fully explore the application of targeted drug delivery, we need to investigate whether the specific diseases are the correct application for targeting, whether the properties of the therapeutic drugs, as well as their site and mode of action, are suited for targeting and whether the delivery vehicles are optimal for product development.[158]

          Key Factors Impacting Drug Delivery

          In order to achieve effective drug delivery, nanocarriers must have suitable circulation time to prevent the elimination of drugs before reaching their target. Based on previous investigations, size, shape and surface characteristics are key factors that impact the efficiency of drug delivery systems.

          Summary

          Nanotechnology is an emerging field with the potential to revolutionize drug delivery. Advances in this area have allowed some nanomedicines in the market to achieve desirable pharmacokinetic properties, reduce toxicity and improve patient compliance, as well as clinical outcomes. Integration of nanoparticulate drug delivery technologies in preformulation work not only accelerates the development of new therapeutic moieties, but also helps in the reduction of attrition of new molecular entities caused by undesirable biopharmaceutical and pharmacokinetic properties.

          Optimizing the integration of nanomaterials into drug delivery systems will require standardized metrics for their classification, as well as protocols for their handling. This will, in turn, result in a better understanding of the interactions of nanomaterials with biological systems, which will facilitate better engineering of their properties specific to biomedical applications. The development of such drug carriers will require a greater understanding of both the surface chemistry of nanomaterials and the interaction chemistry of these nanomaterials with biological systems. This can only be achieved through collaborative efforts among scientists in different disciplines. Those who work in this emerging field should have up-to-date information on related toxicology issues, potential health and safety risks and the regulatory environment that will impact patient use. Understanding both the benefits and the risks of these new nanotechnology applications will be essential to good decision-making for drug developers, regulators and ultimately the consumers and patients who will be the beneficiaries of new drug delivery technologies.

        5. Nanoparticles wrapped inside human platelet membranes serve as new vehicles for targeted drug delivery.

http://www.technologynetworks.com/news.aspx?ID=183111

Nanoparticles disguised as human platelets could greatly enhance the healing power of drug treatments for cardiovascular disease and systemic bacterial infections. These platelet-mimicking nanoparticles, developed by engineers at the University of California, San Diego, are capable of delivering drugs to targeted sites in the body — particularly injured blood vessels, as well as organs infected by harmful bacteria. Engineers demonstrated that by delivering the drugs just to the areas where the drugs were needed, these platelet copycats greatly increased the therapeutic effects of drugs that were administered to diseased rats and mice.

“This work addresses a major challenge in the field of nanomedicine: targeted drug delivery with nanoparticles,” said Liangfang Zhang, a nanoengineering professor at UC San Diego and the senior author of the study. “Because of their targeting ability, platelet-mimicking nanoparticles can directly provide a much higher dose of medication specifically to diseased areas without saturating the entire body with drugs.”

Schematic-of-platelet-nanoparticles-150915-f.jpg

The study is an excellent example of using engineering principles and technology to achieve “precision medicine,” said Shu Chien, a professor of bioengineering and medicine, director of the Institute of Engineering in Medicine at UC San Diego, and a corresponding author on the study. “While this proof of principle study demonstrates specific delivery of therapeutic agents to treat cardiovascular disease and bacterial infections, it also has broad implications for targeted therapy for other diseases such as cancer and neurological disorders,” said Chien.

The ins and outs of the platelet copycats

On the outside, platelet-mimicking nanoparticles are cloaked with human platelet membranes, which enable the nanoparticles to circulate throughout the bloodstream without being attacked by the immune system. The platelet membrane coating has another beneficial feature: it preferentially binds to damaged blood vessels and certain pathogens such as MRSA bacteria, allowing the nanoparticles to deliver and release their drug payloads specifically to these sites in the body.

Enclosed within the platelet membranes are nanoparticle cores made of a biodegradable polymer that can be safely metabolized by the body. The nanoparticles can be packed with many small drug molecules that diffuse out of the polymer core and through the platelet membrane onto their targets.

To make the platelet-membrane-coated nanoparticles, engineers first separated platelets from whole blood samples using a centrifuge. The platelets were then processed to isolate the platelet membranes from the platelet cells. Next, the platelet membranes were broken up into much smaller pieces and fused to the surface of nanoparticle cores. The resulting platelet-membrane-coated nanoparticles are approximately 100 nanometers in diameter, which is one thousand times thinner than an average sheet of paper.

This cloaking technology is based on the strategy that Zhang’s research group had developed to cloak nanoparticles in red blood cell membranes. The researchers previously demonstrated that nanoparticles disguised as red blood cells are capable of removing dangerous pore-forming toxins produced by MRSA, poisonous snake bites and bee stings from the bloodstream.

By using the body’s own platelet membranes, the researchers were able to produce platelet mimics that contain the complete set of surface receptors, antigens and proteins naturally present on platelet membranes. This is unlike other efforts, which synthesize platelet mimics that replicate one or two surface proteins of the platelet membrane.

“Our technique takes advantage of the unique natural properties of human platelet membranes, which have a natural preference to bind to certain tissues and organisms in the body,” said Zhang. This targeting ability, which red blood cell membranes do not have, makes platelet membranes extremely useful for targeted drug delivery, researchers said.

Platelet copycats at work

In one part of this study, researchers packed platelet-mimicking nanoparticles with docetaxel, a drug used to prevent scar tissue formation in the lining of damaged blood vessels, and administered them to rats afflicted with injured arteries. Researchers observed that the docetaxel-containing nanoparticles selectively collected onto the damaged sites of arteries and healed them.

When packed with a small dose of antibiotics, platelet-mimicking nanoparticles can also greatly minimize bacterial infections that have entered the bloodstream and spread to various organs in the body. Researchers injected nanoparticles containing just one-sixth the clinical dose of the antibiotic vancomycin into one of group of mice systemically infected with MRSA bacteria. The organs of these mice ended up with bacterial counts up to one thousand times lower than mice treated with the clinical dose of vancomycin alone.

“Our platelet-mimicking nanoparticles can increase the therapeutic efficacy of antibiotics because they can focus treatment on the bacteria locally without spreading drugs to healthy tissues and organs throughout the rest of the body,” said Zhang. “We hope to develop platelet-mimicking nanoparticles into new treatments for systemic bacterial infections and cardiovascular disease.”

6.  Sponge-like nanoporous gold could be key to new devices to detect disease-causing agents in humans and plants, according to UC Davis researchers.

http://www.technologynetworks.com/news.aspx?ID=182663

A group from the UC Davis Department of Electrical and Computer Engineering have demonstrated that they could detect nucleic acids  using nanoporous gold, a novel sensor coating material, in mixtures of other biomolecules that would gum up most detectors. This method enables sensitive detection of DNA in complex biological samples, such as serum from whole blood.

“Nanoporous gold can be imagined as a porous metal sponge with pore sizes that are a thousand times smaller than the diameter of a human hair,” said Erkin Şeker, assistant professor of electrical and computer engineering at UC Davis and the senior author on the papers. “What happens is the debris in biological samples, such as proteins, is too large to go through those pores, but the fiber-like nucleic acids that we want to detect can actually fit through them. It’s almost like a natural sieve.”

CoverArt_nanoporous_gold.png

Rapid and sensitive detection of nucleic acids plays a crucial role in early identification of pathogenic microbes and disease biomarkers. Current sensor approaches usually require nucleic acid purification that relies on multiple steps and specialized laboratory equipment, which limit the sensors’ use in the field. The researchers’ method reduces the need for purification.

“So now we hope to have largely eliminated the need for extensive sample clean-up, which makes the process conducive to use in the field,” Şeker said.

The result is a faster and more efficient process that can be applied in many settings.

The researchers hope the technology can be translated into the development of miniature point-of-care diagnostic platforms for agricultural and clinical applications.

“The applications of the sensor are quite broad ranging from detection of plant pathogens to disease biomarkers,” said Şeker.

For example, in agriculture, scientists could detect whether a certain pathogen exists on a plant without seeing any symptoms. And in sepsis cases in humans, doctors might determine bacterial contamination much more quickly than at present, preventing any unnecessary treatments.

7.  Pushing the limits of lensless imaging

http://www.rdmag.com/news/2015/09/pushing-limits-lensless-imaging?

The Optical Society

To take a picture with this method, scientists fire an X-ray or extreme ultraviolet laser at a target. The light scatters off, and some of those photons interfere with one another and find their way onto a detector, creating a diffraction pattern. By analyzing that pattern, a computer then reconstructs the path those photons must have taken, which generates an image of the target material—all without the lens that’s required in conventional microscopy.

WASHINGTON — Using ultrafast beams of extreme ultraviolet light streaming at a 100,000 times a second, researchers from the Friedrich Schiller University Jena, Germany, have pushed the boundaries of a well-established imaging technique. Not only did they make the highest resolution images ever achieved with this method at a given wavelength, they also created images fast enough to be used in real time. Their new approach could be used to study everything from semiconductor chips to cancer cells.

The team will present their work at the Frontiers in Optics, The Optical Society’s annual meeting and conference in San Jose, California, USA, on October 22, 2015.

The researchers’ wanted to improve on a lensless imaging technique called coherent diffraction imaging, which has been around since the 1980s. To take a picture with this method, scientists fire an X-ray or extreme ultraviolet laser at a target. The light scatters off, and some of those photons interfere with one another and find their way onto a detector, creating a diffraction pattern. By analyzing that pattern, a computer then reconstructs the path those photons must have taken, which generates an image of the target material—all without the lens that’s required in conventional microscopy.

“The computer does the imaging part—forget about the lens,” explained Michael Zürch, Friedrich Schiller University Jena, Germany and lead researcher. “The computer emulates the lens.”

Without a lens, the quality of the images primarily depends on the radiation source. Traditionally, researchers use big, powerful X-ray beams like the one at the SLAC National Accelerator Laboratory in Menlo Park, CA, USA. Over the last 10 years, researchers have developed smaller, cheaper machines that pump out coherent, laser-like beams in the laboratory setting. While those machines are convenient from the cost perspective, they have drawbacks when reporting results.

The table-top machines are unable to produce as many photons as the big expensive ones which limits their resolution. To achieve higher resolutions, the detector must be placed close to the target material—similar to placing a specimen close to a microscope to boost the magnification. Given the geometry of such short distances, hardly any photons will bounce off the target at large enough angles to reach the detector. Without enough photons, the image quality is reduced.

Zürch and a team of researchers from Jena University used a special, custom-built ultrafast laser that fires extreme ultraviolet photons a hundred times faster than conventional table-top machines. With more photons, at a wavelength of 33 nanometers, the researchers were able to make an image with a resolution of 26 nanometers — almost the theoretical limit. “Nobody has achieved such a high resolution with respect to the wavelength in the extreme ultraviolet before,” Zürch said.

The ultrafast laser also overcame another drawback of conventional table-top light sources: long exposure times. If researchers have to wait for images, they can’t get real-time feedback on the systems they study. Thanks to the new high-speed light source, Zürch and his colleagues have reduced the exposure time to only about a second — fast enough for real-time imaging. When taking snapshots every second, the researchers reached a resolution below 80 nanometers.

The prospect of high-resolution and real-time imaging using such a relatively small setup could lead to all kinds of applications, Zürch said. Engineers can use this to hunt for tiny defects in semiconductor chips. Biologists can zoom in on the organelles that make up a cell. Eventually, he said, the researchers might be able to cut down on the exposure times even more and reach even higher resolution levels.

About FiO/LS

Frontiers in Optics (FiO) 2015 is The Optical Society’s (OSA) 99th Annual Meeting and is being held together with Laser Science, the 31th annual meeting of the American Physical Society (APS) Division of Laser Science (DLS). The two meetings unite the OSA and APS communities for five days of quality, cutting-edge presentations, in-demand invited speakers and a variety of special events spanning a broad range of topics in optics and photonics—the science of light—across the disciplines of physics, biology and chemistry. The exhibit floor will feature leading optics companies, technology products and programs.

About The Optical Society

Founded in 1916, The Optical Society (OSA) is a leading professional organization for scientists, engineers, students and entrepreneurs who fuel discoveries, shape real-life applications and accelerate achievements in the science of light. Through world-renowned publications, meetings and membership initiatives, OSA provides quality research, inspired interactions and dedicated resources for its extensive global network of optics and photonics experts. OSA is a founding partner of the National Photonics Initiative and the 2015 International Year of Light.

SOURCE: The Optical Society

8.  Physicists determine three-dimensional positions of individual atoms for the first time
http://www.rdmag.com/news/2015/09/physicists-determine-three-dimensional-positions-individual-atoms-first-time?

Katherine Kornei, UCLA
The scientists were able to plot the exact coordinates of nine layers of atoms with a precision of 19 trillionths of a meter. Courtesy of Mary Scott and Jianwei (John) Miao/UCLAAtoms are the building blocks of all matter on Earth, and the patterns in which they are arranged dictate how strong, conductive or flexible a material will be. Now, scientists at UCLA have used a powerful microscope to image the three-dimensional positions of individual atoms to a precision of 19 trillionths of a meter, which is several times smaller than a hydrogen atom.

Their observations make it possible, for the first time, to infer the macroscopic properties of materials based on their structural arrangements of atoms, which will guide how scientists and engineers build aircraft components, for example. The research, led by Jianwei (John) Miao, a UCLA professor of physics and astronomy and a member of UCLA’s California NanoSystems Institute, is published September 21 in the online edition of the journal Nature Materials.

For more than 100 years, researchers have inferred how atoms are arranged in three-dimensional space using a technique called X-ray crystallography, which involves measuring how light waves scatter off of a crystal. However, X-ray crystallography only yields information about the average positions of many billions of atoms in the crystal, and not about individual atoms’ precise coordinates.

“It’s like taking an average of people on Earth,” Miao said. “Most people have a head, two eyes, a nose and two ears. But an image of the average person will still look different from you and me.”

Because X-ray crystallography doesn’t reveal the structure of a material on a per-atom basis, the technique can’t identify tiny imperfections in materials, such as the absence of a single atom. These imperfections, known as point defects, can weaken materials, which can be dangerous when the materials are components of machines like jet engines.

“Point defects are very important to modern science and technology,” Miao said.

Miao and his team used a technique known as scanning transmission electron microscopy, in which a beam of electrons smaller than the size of a hydrogen atom is scanned over a sample and measures how many electrons interact with the atoms at each scan position. The method reveals the atomic structure of materials because different arrangements of atoms cause electrons to interact in different ways.

However, scanning transmission electron microscopes only produce two-dimensional images. So, creating a 3-D picture requires scientists to scan the sample once, tilt it by a few degrees and re-scan it—repeating the process until the desired spatial resolution is achieved—before combining the data from each scan using a computer algorithm. The downside of this technique is that the repeated electron beam radiation can progressively damage the sample.

Using a scanning transmission electron microscope at the Lawrence Berkeley National Laboratory’s Molecular Foundry, Miao and his colleagues analyzed a small piece of tungsten, an element used in incandescent light bulbs. As the sample was tilted 62 times, the researchers were able to slowly assemble a 3-D model of 3,769 atoms in the tip of the tungsten sample.

The experiment was time consuming because the researchers had to wait several minutes after each tilt for the setup to stabilize.

“Our measurements are so precise, and any vibrations—like a person walking by—can affect what we measure,” said Peter Ercius, a staff scientist at Lawrence Berkeley National Laboratory and an author of the paper.

The researchers compared the images from the first and last scans to verify that the tungsten had not been damaged by the radiation, thanks to the electron beam energy being kept below the radiation damage threshold of tungsten.

Miao and his team showed that the atoms in the tip of the tungsten sample were arranged in nine layers, the sixth of which contained a point defect. The researchers believe the defect was either a hole in an otherwise filled layer of atoms or one or more interloping atoms of a lighter element such as carbon.

Regardless of the nature of the point defect, the researchers’ ability to detect its presence is significant, demonstrating for the first time that the coordinates of individual atoms and point defects can be recorded in three dimensions.

“We made a big breakthrough,” Miao said.

Miao and his team plan to build on their results by studying how atoms are arranged in materials that possess magnetism or energy storage functions, which will help inform our understanding of the properties of these important materials at the most fundamental scale.

“I think this work will create a paradigm shift in how materials are characterized in the 21st century,” he said. “Point defects strongly influence a material’s properties and are discussed in many physics and materials science textbooks. Our results are the first experimental determination of a point defect inside a material in three dimensions.”

The study’s co-authors include Rui Xu, Chien-Chun Chen, Li Wu, Mary Scott, Matthias Bartels, Yongsoo Yang and Michael Sawaya, all of UCLA; as well as Colin Ophus of Lawrence Berkeley National Laboratory; Wolfgang Theis of the University of Birmingham; Hadi Ramezani-Dakhel and Hendrik Heinz of the University of Akron; and Laurence Marks of Northwestern University.

This work was primarily supported by the U.S. Department of Energy’s Office of Basic Energy Sciences (grant DE-FG02-13ER46943 and contract DE-AC02—05CH11231).

9.  An SDSU chemist has developed a technique to identify potential cancer drugs that are less likely to produce side effects.

http://www.technologynetworks.com/medchem/news.aspx?ID=183124

A class of therapeutic drugs known as protein kinase inhibitors has in the past decade become a powerful weapon in the fight against various life-threatening diseases, including certain types of leukemia, lung cancer, kidney cancer and squamous cell cancer of the head and neck. One problem with these drugs, however, is that they often inhibit many different targets, which can lead to side effects and complications in therapeutic use. A recent study by San Diego State University chemist Jeffrey Gustafson has identified a new technique for improving the selectivity of these drugs and possibly decreasing unwanted side effects in the future.

Why are protein kinase–inhibiting drugs so unpredictable? The answer lies in their molecular makeup.

Many of these drug candidates possess examples of a phenomenon known as atropisomerism. To understand what this is, it’s helpful to understand a bit of the chemistry at work. Molecules can come in different forms that have exactly the same chemical formula and even the same bonds, just arranged differently. The different arrangements are mirror images of each other, with a left-handed and a right-handed arrangement. The molecules’ “handedness” is referred to as chirality. Atropisomerism is a form of chirality that arises when the spatial arrangement has a rotatable bond called an axis of chirality. Picture two non-identical paper snowflakes tethered together by a rigid stick.

Some axes of chirality are rigid, while others can freely spin about their axis. In the latter case, this means that at any given time, you could have one of two different “versions” of the same molecule.

Watershed treatment

As the name suggests, kinase inhibitors interrupt the function of kinases—a particular type of enzyme—and effectively shut down the activity of proteins that contribute to cancer.

“Kinase inhibition has been a watershed for cancer treatment,” said Gustafson, who attended SDSU as an undergraduate before earning his Ph.D. in organic chemistry from Yale University, then working there as a National Institutes of Health poctdoctoral fellow in chemical biology.

“However, it’s really hard to inhibit a single kinase,” he explained. “The majority of compounds identified inhibit not just one but many kinases, and that can lead to a number of side effects.”

Many kinase inhibitors possess axes of chirality that are freely spinning. The problem is that because you can’t control which “arrangement” of the molecule is present at a given time, the unwanted version could have unintended consequences.

In practice, this means that when medicinal chemists discover a promising kinase inhibitor that exists as two interchanging arrangements, they actually have two different inhibitors. Each one can have quite different biological effects, and it’s difficult to know which version of the molecule actually targets the right protein.

“I think this has really been under-recognized in the field,” Gustafson said. “The field needs strategies to weed out these side effects.”

Applying the brakes

So that’s what Gustafson did in a recently published study. He and his colleagues synthesized atropisomeric compounds known to target a particular family of kinases known as tyrosine kinases. To some of these compounds, the researchers added a single chlorine atom which effectively served as a brake to keep the atropisomer from spinning around, locking the molecule into either a right-handed or a left-handed version.

When the researchers screened both the modified and unmodified versions against their target kinases, they found major differences in which kinases the different versions inhibited. The unmodified compound was like a shotgun blast, inhibiting a broad range of kinases. But the locked-in right-handed and left-handed versions were choosier.

“Just by locking them into one or another atropisomeric configuration, not only were they more selective, but they inhibited different kinases,” Gustafson explained.

If drug makers incorporated this technique into their early drug discovery process, he said, it would help identify which version of an atropisomeric compound actually targets the kinase they want to target, cutting the potential for side effects and helping to usher drugs past strict regulatory hurdles and into the hands of waiting patients.

11.  ‘Nanocubes’ Make PSA Test Over 100 Times More Sensitive

http://www.mdtmag.com/news/2015/09/nanocubes-make-psa-test-over-100-times-more-sensitive?

A new catalyst that improves the sensitivity of the standard PSA test more than 100-fold, pictured above, is made of palladium nanocubes coated with iridium. (Credit: Xiaohu Xia, Michigan Technological University)

Say you’ve been diagnosed with prostate cancer, the second-leading cause of cancer death in men. You opt for surgery to remove your prostate. Three months later, a prostate surface antigen (PSA) test shows no prostate cells in your body. Everyone rejoices.

Until 18 months later, when another PSA test reveals that now prostate cells have reappeared. What happened?

The first PSA test yielded what’s known as a false negative result. It did not detect the handful of cells that remained after surgery and later multiplied. Now a chemist at Michigan Technological University has made a discovery that could, among other things, slash the numbers of false negatives in PSA tests.

Xiaohu Xia and his team, including researchers from Louisiana State University and the University of Texas at Dallas, have developed a new catalyst that could make lab tests like the PSA much more sensitive. And it may even speed up reactions that neutralize toxic industrial chemicals before they enter lakes and streams.

A paper on the research, “Pd-Ir Core-Shell Nanocubes: A Type of Highly Efficient and Versatile Peroxidase Mimic,” was published online Sept. 3 in ACS Nano. In addition to Xia, the coauthors are graduate students Jingtuo Zhang, Jiabin Liu and Haihang Ye and undergraduate Erin McKenzie of Michigan Tech; Moon J. Kim and Ning Lu of the University of Texas at Dallas; and Ye Xu and Kushal Ghale of Louisiana State University. The LSU team conducted theoretical calculations, and the UT Dallas team contributed high-resolution electron microscopy images.

Their new catalyst mimics the action of similar biochemicals found in nature, called peroxidases. “In animals and plants, these peroxidases are important– for example, they get rid of hydrogen peroxide, which is harmful to the organism,” said Xia, an assistant professor of chemistry at Michigan Tech. In medicine, peroxidases have become powerful tools for accelerating chemical reactions in diagnostic tests; a peroxidase found in the horseradish root is commonly used in the standard PSA test.

However, these natural peroxidases have drawbacks. They can be difficult to extract and purify. “And, they are made of protein, which isn’t very stable,” Xia explained. “At high temperatures, they cook, like meat.”

“Moreover, their efficiency is just fair,” he added. “We wanted to develop a mimic peroxidase that was substantially more efficient than the natural peroxidase, which would lead to a more-sensitive PSA test.”

Their new catalyst, made from nanoscale cubes of palladium coated with a few layers of iridium atoms, does just that. PSA tests Xia’s team conducted using the palladium-iridium catalyst were 110 times more sensitive than tests completed with the conventional peroxidase.

“After surgery, it’s vital to detect a tiny amount of prostate antigen, because otherwise you can get a false negative and perhaps delay treatment for cancer,” said Xia. “Our ultimate goal is to further refine our system for use in clinical diagnostic laboratories.”

Xia hopes that his mimic peroxidase will someday save lives through earlier detection of cancer and other maladies. He also plans to explore other applications, including how it compares with horseradish peroxidase in other catalytic reactions: breaking down toxic industrial-waste products like phenols into harmless substances.

Finally, the team wants to better understand why its palladium-iridium catalyst works so well. “We know the iridium coating is the key,” Xia said. “We think it makes the surface sticky, so the chemical reagents bind to it better.”

12.  Using Proteomics To Understand How Genetic Mutations Rewire Cancer Cells

http://www.laboratorynetwork.com/doc/using-proteomics-to-understand-genetic-mutations-rewire-cancer-cells-0001?

SAN JOSE, Calif.–(BUSINESS WIRE)–Thermo Fisher Scientific and the Biotech Research and Innovation Center (BRIC) at the University of Copenhagen (UCPH) have shared results from two important scientific papers that advance understanding of how gene mutations drive cancer progression. The two landmark studies, published this week in the journal ; CELL, are some of the early results of the strategic collaboration between Thermo Fisher Scientific and the Linding Lab at BRIC, UCPH.

Using advanced Thermo Scientific Orbitrap Fusion mass spectrometry and next-generation sequencing technologies, researchers from the Universities of Copenhagen, Yale, Zurich, Rome and Tottori describe how specific cancer mutations target and damage the protein signaling networks within human cells on a global scale.

By developing advanced algorithms to integrate data from quantitative mass-spectrometry and next generation sequencing of tumor samples, the researchers have been able to uncover cancer-related changes to phosphorylation signaling networks. This new breakthrough allows researchers to identify the effects of mutations on the function of protein pathways in cancer for individual patients, even if those mutations are very rare.

Lead BRIC researcher Dr. Rune Linding said: “The identification of distinct changes within our tissues that could have the potential to help predict and treat cancer is a major step forward and we are confident that it can aid in the development of novel therapies and screening techniques.”

Since the human genome was decoded more than a decade ago, large scale cancer genome studies have successfully identified gene mutations in individual patients and tumors. However to develop improved cancer therapies, researchers need to explain and relate this genomic data to proteins, the targets of most pharmaceutical drugs. Creating this linkage provides powerful new insights into cancer biology and potential therapeutic approaches.

“The studies highlight the importance of integrating proteomics with genomics in future cancer studies and underscores the value of the broad technological expertise within Thermo Fisher,” said Ken Miller, vice president of research product marketing, life sciences mass spectrometry at Thermo Fisher. “It is becoming increasingly apparent that the genetic basis for each patient’s cancer is subtly, but importantly, different. This realization will inevitably lead to a need for tools to acquire and assess patient-specific information to develop highly personalized therapies with the potential for much greater efficacy. It is hoped that the novel approaches described in these studies, together with best-in-class enabling technologies such as the Orbitrap and Ion Torrent systems, will continue to improve our knowledge of cancer biology.”

The Biotech Research & Innovation Centre (BRIC) was established in 2003 by the Danish Ministry of Science, Technology and Innovation to form an elite centre in biomedical research.

The two studies will be available in advance online and printed in the 24th September issue of CELL, a premier journal in life and biological sciences. More information about the studies and links to media content can be found on http://www.lindinglab.science and http://www.bric.ku.dk. The work was supported by the European Research Council (ERC), the Lundbeck Foundation and Human Frontier Science Program.

13.  Multi-Ancestry GWAS Uncovers a Dozen New Loci Linked to Blood Pressure

Sep 21, 2015

https://www.genomeweb.com/cardiovascular-disease/multi-ancestry-gwas-uncovers-dozen-new-loci-linked-blood-pressure?

NEW YORK (GenomeWeb) – In Nature Genetics, an international team described a dozen new loci influencing blood pressure patterns across individuals from multiple populations — a set that overlaps with variants implicated in epigenetic features of blood and other tissues.

Through a multi-stage genome-wide association study that relied on genotyping information for as many as 320,251 individuals of East Asian, South Asian, and European descent, the researchers focused in on SNPs at 12 blood pressure-associated sites in the genome, including loci previously linked to cardiac or metabolic functions.

In particular, the team saw blood pressure-linked variants in and around genes contributing to vascular smooth muscle and renal function. And a large proportion of the associated SNPs — or variants in linkage disequilibrium with them — turned up at sites already implicated in control of DNA methylation.

“We note an effect of genome-wide-associated sentinel SNPs on DNA methylation for traits in addition to blood pressure, suggesting that DNA methylation might have a wider role in linking common genetic variation to multiple phenotypes,” the study’s authors wrote.

More than a billion people around the world are affected by high blood pressure, the team explained, a condition that elevates the risk of heart disease, heart attack, stroke, and chronic kidney disease.

Because it occurs at especially high rates in East Asian and South Asian populations, the investigators reasoned that it might be possible to find both ancestry-specific and trans-ancestral genetic associations with high blood pressure.

The team started by analyzing imputed and directly genotyped SNPs in 31,516 individuals of East Asian ancestry, 35,352 individuals with European ancestry, and 33,126 individuals of South Asian descent, searching for variants associated with systolic blood pressure, diastolic blood pressure, pulse pressure, mean arterial pressure, and hypertension.

Through analyses on each population individually and in a meta-analysis of individuals from all three populations, the researchers initially identified 630 loci with suspected ties to at least one of the five blood pressure traits considered.

They then compared the top SNP at each site against data on as many as 87,205 individuals tested for various blood pressure traits for the International Consortium on Blood Pressure GWAS, narrowing in on 19 loci with potential ties to blood pressure that were not described in the past.

The team confirmed blood pressure associations for SNPs at 12 of the new loci through testing on another 48,268 East Asians, 68,456 Europeans, and 16,328 South Asians.

The analysis also verified almost two-dozen loci linked to blood pressure in the past and pointed to 17 sites in the genome with weaker ties to the traits of interest.

Variants at the 12 new loci seemed to have similar effects on the five traits in question, regardless of the population considered, while variants that first appeared to show population-specific effects in East Asians and Europeans did not pan out in replication testing.

By folding in linkage disequilibrium patterns for SNPs at the new blood pressure-associated sites, the researchers got a look at genes that fall near these linked SNPs — a collection that includes genes such as PDE3A, KCNK3, and PRDM6.

They also used these linkage patterns to look for overlap with DNA methylation-related SNPs, demonstrating that 28 of 35 SNPs at these loci seem to be linked to altered DNA methylation levels and related expression shifts in samples from thousands of Europeans or East Asians.

And the team saw similar effects in hundreds of cord blood samples subjected to methylation profiling, suggesting the effect is not simply a consequence of high blood pressure itself.

“The presence of these associations at an early stage of life, before substantial environmental exposure, lends support to the view that the sequence variants have a direct effect on DNA methylation and argues against reverse causation,” the study authors wrote.

14.  Elabela, A New Human Embryonic Stem Cell Growth Factor

September 20, 2015 by mburatov

When embryonic stem cell lines are made, they are traditionally grown on a layer of “feeder cells” that secrete growth factors that keep the embryonic stem cells (ESCs) from differentiating and drive them to grow. These feeder cells are usually irradiated mouse fibroblasts that coat the culture dish, but do not divide. Mouse ESCs can be grown without feeder cells if the growth factor LIF is provided in the medium. LIF, however, is not the growth factor required by human ESCs, and therefore, designing culture media for human ESCs to help them grow without feeder cells has proven more difficult.

Having said that, several laboratories have designed media that can be used to derive human embryonic stem cells without feeder cells. Such a procedure is very important if such cells are to be used for therapeutic purposes, since animal cells can harbor difficult to detect viruses and unusual sugars on their cell surfaces that can also be transferred to human ESCs in culture. These unusual sugars can elicit a strong immune response against them, and for this reason, ESCs must be cultivated or derived under cell-free conditions. However, to design good cell-free culture media, we must know more about the growth factors required by ESCs.

To that end, Bruno Reversade from The Institute of Molecular and Cell Biology in Singapore and others have identified a new growth factor that human ESCs secrete themselves. This protein, ELABELA (ELA), was first identified as a signal for heart development. However, Reversade’s laboratory has discovered that ELA is also abundantly secreted by human ESCs and is required for human ESCs to maintain their ability to self-renew.

Reversade and others deleted the ELA gene with the CRISPR/Cas9 system, and they also knocked the expression of this gene down in other cells with small interfering RNAs. Alternatively, they also incubated human ESCs with antibodies against ELA, which neutralized ELA and prevented it from binding to the cell surface. However Ela was inhibited, the results were the same; reduced ESC growth, increased amounts of cell death, and loss of pluripotency.

How does ELA signal to cells to grow? Global signaling studies of growing human ESCs showed that ELA activates the PI3K/AKT/mTORC1 signaling pathway, which has been show in other work to be required for cell survival. By activating this pathway, ELA drives human ESCs through the cell-cycle progression, activates protein synthesis, and inhibits stress-induced apoptosis.

Interestingly, INSULIN and ELA have partially overlapping functions in human ESC culture medium, but only ELA seems to prime human ESCs toward the endoderm lineage. In the heart, ELA binds to the Apelin receptor APLNR. This receptor, however, is not expressed in human ESCs, which suggests that another receptor, whose identity remains unknown at the moment, binds ELA in human ESCs.

Thus ELA seems to act through an alternate cell-surface receptor, is an endogenous secreted growth factor in human

This paper was published in the journal Cell Stem Cell.

15.  Multiwavelength TIRF Microscopy Enables Insight into Actin Filaments

http://www.photonics.com/Article.aspx?PID=1&AID=57707

Researchers at the University of California, San Francisco (UCSF) are combining multiple laser excitation wavelengths in total internal reflection fluorescence (TIRF) microscopy to investigate the binding dynamics of individual actin filaments.

DAN CALLEN, COHERENT INC.

TIRF microscopy provides a unique method of imaging isolated molecules and complexes in vitro. Additionally, the use of sensitive, low-noise cameras enables researchers to study this behavior in real time. A new plug-and-play method of combining several fiber-delivered, digitally modulated lasers into a single instrument, such as a TIRF microscope, now enables multiple labeled proteins to be imaged pseudosimultaneously at high frame rates. This article explores how multiwavelength excitation is being combined with TIRF microscopy in the laboratory of Dr. Dyche Mullins, a professor at UCSF, and how it’s being used to gain new insights into complex biochemical interactions that control the stability and function of actin filaments.

TIRF microscopy in single-filament studies

The Mullins Lab, located at UCSF’s Mission Bay campus, is widely recognized as a leading authority on the study of actin filaments. The protein filaments are fundamental to many processes in virtually every eukaryotic cell — they act as structural elements that enable movement of internal cargoes, amoeboid cell migration, cell division, etc. With these filaments playing so many different roles, it is not surprising that their combination of growth, branching, aggregation and movement involves many subtle control options, which are mediated by a range of different proteins. Sam Lord, the Mullins Lab’s microscope specialist, said, “One area of our research is studying how various proteins bind to actin filaments to enable aggregation, branching and other actions, and more specifically, how yet another set of proteins modulates these binding processes. Obviously, we do bulk studies in a cuvette that reveal overall kinetic data about these binding processes but we also want to image these processes in real time to study the structural biochemistry.” In order to do so, the lab uses TIRF microscopy to observe single actin filaments.

This process involves excitation light that is introduced into the sample region through either a glass slide or a cover slip. The microscope’s optics are configured so that the light hits the glass/sample interface beyond the critical angle, meaning that all of the light will undergo total internal reflection (TIR). However, even with TIR, some of the light’s electric field, called the evanescent wave, penetrates into the sample by an incredibly short distance — typically around 100 nm — beyond the interface. This means that TIRF microscopy can be used to selectively excite fluorescence in molecules and complexes that are adhered to the interface. However, because the light does not penetrate into the bulk (i.e., background) sample region, this methodology will not excite fluorescence from the huge backdrop of molecules freely floating within this medium.

TIRF microscopy is thus a 3D-resolved imaging technique. Its X-Y resolution is limited only by diffraction and/or the camera resolution, but the Z-axis sampling depth is much smaller than the diffraction limit. If there is sufficient signal for fast frame acquisition speeds, the important fourth dimension — time — enables dynamic processes, such as actin filament-protein binding, to be observed on a single filament or on a network of filaments, in real time.

In principle, both laser and nonlaser light sources may be used for fluorescence excitation in such TIRF-based applications. However, for experiments with naturally low signal levels, such as single-molecule monitoring, a laser beam’s extreme brightness is a critical advantage. In particular, a laser’s unique spatial brightness means that it is relatively simple to collimate and subsequently focus the beam into the sample with a narrow range of incidence angles, avoiding excitation of the bulk sample.

Through-objective TIRF microscopy

All TIRF microscope setups are based on one of two basic approaches: through-objective lens geometry or the prism-based method. In the former approach, light is directed in an off-axis geometry through an oil-immersion microscope objective so that the angle of incidence at the coverslip/sample interface is greater than the critical angle, as is shown schematically in Figure 1.


Figure 1.
 In TIRF microscopy, excitation light beyond the critical light is completely reflected. The evanescence of the light field at the refractive interface penetrates into the sample by about 100 nm, causing selective excitation of molecules and complexes adhered to this interface. TIRF microscopes are available with a choice of either through-objective excitation or prism excitation options.
In the prism-based method, the orientation of the sample is reversed with respect to the imaging objective. A light beam is introduced to the sample through a prism attached to the cover slip; the geometry of the prism ensures that the incidence angle at the sample is greater than the critical angle.

Depending on the type of experiment being performed, there are both advantages and disadvantages to each of the above methods. For example, the prism method limits physical access to the sample. As Lord explained, the Mullins Lab uses a Nikon microscope in the through-objective configuration with a very high numerical aperture (NA = 1.49) for several reasons. “For single-molecule studies, fluorescence signal strength is always a major challenge, particularly since we are following processes that need fast frame rates. So, we need a high-NA objective with a small working distance to maximize light collection efficiency. These objectives require a coverglass of precise thickness and the sample near the top of the coverslip to minimize aberrations.” Lord also stated that caution must be taken so the team does not introduce scattering and other losses due to viewing fluorescence through the bulk of the sample.

Multiple, simultaneous laser wavelengths

As has been noted, the mechanisms controlling the binding of regulatory proteins to actin filaments are quite complex. To better understand these processes, the Mullins Lab increasingly has been using sophisticated, multiwavelength TIRF-based experiments. In order to image multiple fluorophores, Lord explained, “We can use either multiple sequenced lasers or a scope equipped with multiple cameras — we have setups for both arrangements.” He continued, “Multiple excitation wavelengths that sequence at high rates enable us to selectively image multiple, differently labeled targets using a microscope equipped with a single high-sensitivity camera, and ensures near-perfect image registration.”

When using multiple lasers, the two technical challenges are to perfectly coalign the lasers into the microscope objective and then to be able to switch between different wavelengths. In order to follow fast binding processes in real time, researchers typically must switch wavelengths between alternate camera frames to build up pseudosimultaneous (i.e., interleaved) videos at two or sometimes three laser wavelengths. This switching must be performed with no undesirable dead time (i.e., shifts in the beam path) and without using mechanical shutters or a complex and costly approach, such as an acousto-optic tunable filter.

Lord notes, “As recently as five years ago, we simply didn’t have low-cost options to conduct single molecule studies using multiple laser wavelengths pseudosimultaneously at the requisite frame rates (30 fps) in order to follow critical binding processes.” He added, “Digitally controllable diode or solid-state lasers, hardware sequencing electronics and quad-band optical filters make it possible to achieve nearly simultaneous multicolor imaging with a single camera.”

In 2014, the lab acquired several digitally modulatable smart lasers to enable multiwavelength TIRF microscopy. These lasers included Coherent’s fiber-pigtailed OBIS FP modules that operate at 488, 561 and 640 nm. The lab also acquired the OBIS Galaxy, which enables simple plug-and-play combining of up to eight fiber-coupled lasers into one, single-mode output fiber. As was detailed by Coherent’s Dan Callen and Matthias Schulze in BioPhotonics’ November 2014 issue (“Laser Combiner Enables Scanning Fluorescence Endoscopy,” www.photonics.com/A56915), this passive module enables lasers to be added or subtracted (i.e., hot-swapped) to any fiber-coupled instrument or setup in a few minutes or less via standard fiber connectors, such as FC/UFC and FC/APC connectors.

Figure 2. The OBIS Galaxy (shown with the top cover removed) allows plug-and-play combining of up to eight separate fiber coupled lasers into a single output fiber. Courtesy of Sam Lord.
The timing hardware setup at the Mullins Lab is very simple in design due to the fact that these smart lasers support direct digital modulation. In each experiment, the frame rate is set by the microscope’s high-sensitivity camera, which is an Andor DU897. The camera’s TTL output trigger pulses are processed in either a programmable Arduino board or an ESio controller, which then directs TTL pulses to fire one of the three lasers without any hardware or software delays. Alternating wavelengths typically are used in most experiments, although any sequence of wavelength frames easily can be programed using the Arduino and Micro-Manager software.1

According to Lord, the flexibility of this arrangement supports future experimental setups that have even greater levels of complexity. In particular, he added, “We may well add a 405-nm laser option in the near future. If/when this arrives, we can simply plug it in and we are ready to go.”

Investigating modulation of actin binding processes

In the team’s work on the binding of actin filaments, this flexible TIRF setup enables the Mullins Lab to conduct experiments with several different approaches. For example, in typical two-wavelength experiments, the actin filament is labeled with one fluorophore, and the protein of interest is labeled with another fluorophore. The protein fluorophore only appears in the TIRF-produced images if/when it binds to the actin sitting on the cover slip. One use of the third wavelength is to image a second protein, which is labeled with a different fluorophore. The image sequences then may reveal, for example, whether the proteins are interspersed at different sites on the filament, or whether the second protein promotes filament growth or branching from a new site. Or, it may reveal that the second protein competitively displaces the first.

In a recently published study,2 Mullins Lab researchers used their multilaser TIRF setup to investigate the details of control mechanisms associated with the binding of tropomyosins to actin filaments. Tropomyosins are coiled-coil proteins whose known functions are to bind actin filaments and thereby regulate multiple cytoskeletal functions — including actin network dynamics near the leading edge of motile cells.

Mullins explained, “The binding of tropomyosins to actin filaments is known to be fundamentally important in actin dynamics. But, we do not yet fully understand how this binding is regulated, especially near the leading edge of migrating cells. Why, for example, are filaments in the lamellum coated with tropomyosin while filaments in the adjacent lamellipod are not?” (Lamellum and lamellipod are distinct, actin-based substructures involved in cell migration.) He went on to state that, prior to his team’s latest studies, previous research demonstrated that tropomyosins inhibit actin nucleation by the Arp2/3 protein complex and that this, in turn, prevented filament severing by the protein cofilin.3,4 “So, we have recently used TIRF and other methods to investigate if and how the Arp2/3 complex and cofilin in turn modulate the binding of tropomyosins to actin filaments,” he said.


Figure 3.
 TIRF images showing Tm1A binding preferentially to the pointed end of single actin filaments. The red signal is from Cy5 labeled Tm1A fluorescence excited at 640 nm, and the green signal is due to Alexa 488 labeled actin excited at 488 nm. Courtesy of J.Y. Hsiao, L.M. Goins, N.A. Petek, R.D. Mullins.
The team members studied these interactions in the specific case of nonmuscle Drosophila tropomyosin protein, Tm1A. They also compared some of these interactions in Tm1A to the same interactions in rabbit skeletal muscle tropomyosin, as other researchers previously have found that mammalian skeletal muscle tropomyosin is the least-effective Arp2/3 inhibitor.2

Data from dual-wavelength excitation produced by TIRF microscopy methodology when applied to single filaments is shown in Figure 3. This information shows that Tm1A preferentially binds near the pointed end of actin filaments. By comparing similar data that resulted from different experimental conditions, the researchers showed that pointed-end binding is dependent on the nucleotide state of the actin and the Tm1A concentration.

Although a complete evaluation of all of the research’s results, conclusions and wider implications falls outside the scope of this article, Mullins does summarize some of the key points. “Binding of cyto-skeletal tropomyosin to actin filaments turns out to be more complicated than previously appreciated. Both nucleation and spreading of tropomyosin are strongly influenced by the conformation of the actin filament and the presence of other regulatory proteins.” Mullins added that, based on TIRF-produced images and other collected data, “We have been able to propose a model where the cooperation of the severing activity of cofilin and tropomyosin binding helps establish the border between the lamellipod and lamellum.” The role of cofilin in the model referenced by Mullin is shown in Figure 4.


Figure 4.
 These images summarize the role of cofilin in the model proposed by Hsaio et al. [ref]. The branched actin network on the left shows the situation in the absence of cofilin, where tropomyosin binding is blocked by Arp2/3 branches. The branched actin network on the right illustrates that in the presence of cofilin, new pointed ends are created, which allows tropomyosin to bind. Once tropomyosin is bound, it protects the actin filaments from further cofilin severing, possibly resulting in the transition from the lamellipod to the lamellum. Courtesy of J.Y. Hsiao, L.M. Goins, N.A. Petek, R.D. Mullins.
In summation, TIRF microscopy is a well-established technique for imaging single molecular structures and protein complexes. This method also enables their respective dynamics to be observed in real time. By providing a method to rapidly switch between two or more excitation wavelengths, the latest lasers and laser-combining technologies are now enabling researchers to perform TIRF microscopy experiments with a greater number of separate labels. This capability is delivering unique insights into important and multifaceted processes in the study of cell biology.

Meet the author

Dan Callen is a product manager at Coherent Inc. in Santa Clara, Calif.; email: daniel.callen@coherent.com.

References

1. A.D. Edelstein et al. (2014). Advanced methods of microscope control using μManager software. J Biol Methods, Vol. 1, No. 2, e10.

2. J.Y. Hsiao et al. (2015). Arp2/3 complex and cofilin modulate binding of tropomyosin to branched actin networks. Curr Biol, pp. 1-10.

3. L. Blanchoin et al. (2001). Inhibition of the Arp2/3 complex-nucleated actin polymerization and branch formation by tropomyosin. Curr Biol, Vol. 11, No. 16, pp. 1300-1304.

4. J.H. Iwasa and R.D. Mullins (2007). Spatial and temporal relationships between actin-filament nucleation, capping and disassembly. Curr Biol, Vol. 17, No. 5, pp. 395-406.

18.  Using QCLs for MIR-Based Spectral Imaging — Applications in Tissue Pathology

http://www.photonics.com/Article.aspx?PID=1&AID=57708

A quantum cascade laser (QCL) microscope allows for fast data acquisition, real-time chemical imaging and the ability to collect only spectral frequencies of interest. Due to their high-quality, highly tunable illumination characteristics and excellent signal-to-noise performance, QCLs are paving the way for the next generation of mid-infrared (MIR) imaging methodologies.

MICHAEL WALSH, UNIVERSITY OF ILLINOIS AT CHICAGO; MATTHEW BARRE & BENJAMIN BIRD, DAYLIGHT SOLUTIONS

H. Sreedhar*1, V. Varma*2, A. Graham3, Z. Richards1, F. Gambacorata4, A. Bhatt1,
P. Nguyen1, K. Meinke1, L. Nonn1, G. Guzman1, E. Fotheringham5, M. Weida5,
D. Arnone5, B. Mohar5, J. Rowlette5
Real-time, MIR chemical imaging microscopes could soon become powerful frontline screening tools for practicing pathologists. The ability to see differences in the biochemical makeup across a tissue sample greatly enhances a practioner’s ability to detect early stages of disease or disease variants. Today, this is accomplished much as it was 100 years ago — through the use of specially formulated stains and dyes in combination with white light microscopy. A new MIR, QCL-based microscope from Daylight Solutions enables real-time, nondestructive biochemical imaging of tissues without the need to perturb the sample with chemical or heat treatments, thus preserving the sample for follow-on fluorescence tagging, histochemical staining or other “omics” testing within the workflow.
MIR chemical imaging is a well-established absorbance spectroscopy technique; it senses the relative amount of light that molecules absorb due to their unique vibrational resonances falling within the MIR portion of the electromagnetic spectrum (i.e., wavelengths from approximately 2 to 15 µm). This absorption can be detected with a variety of MIR detector types and can provide detailed information about the sample’s chemical composition.

The most common instrument for this type of measurement is known as a Fourier transform infrared (FTIR) spectrometer. FTIR systems use a broadband MIR light source, known as a globar, to illuminate a sample; the absorption spectrum is generated by the use of interferometry. Throughout the past decade, FTIR systems have incorporated linear arrays and 2D focal plane arrays (FPAs) in a microscope configuration to enable a technique known as chemical imaging.

19.  Inner Ear Undertakers

Support cells in the inner ear respond differently to two drugs that kill hair cells.

By Kerry Grens | September 1, 2015

http://www.the-scientist.com//?articles.view/articleNo/43824/title/Inner-Ear-Undertakers/

The paper
E.L. Monzack et al., “Live imaging the phagocytic activity of inner ear supporting cells in response to hair cell death,” Cell Death Differ, doi:10.1038/cdd.2015.48, 2015.

Killer drugs
A number of commonly used medications can cause hearing loss by killing off cochlear hair cells, which translate sound waves into neural activity. To understand how they die, Lisa Cunningham and Elyssa Monzack of the National Institute on Deafness and Other Communication Disorders and colleagues turned to the utricle, a vestibular inner-ear structure involved with balance whose hair cells are very similar to those in the cochlea, which are notoriously resistant to culturing when mature.

Body bags
The team developed a method to watch hair cells of whole mouse utricles die in real time after exposure to the chemotherapy drug cisplatin or the antibiotic neomycin. In response to the latter, supporting cells, glia-like neighbors of hair cells, appeared to form a phagosome around the corpses and engulf them. “You can see two, three, sometimes four supporting cells advancing simultaneously on that hair cell corpse,” says Cunningham—which suggests that the dying cell is giving off a specific and local signal.

Spilled guts
In contrast, cisplatin-induced hair cell death provoked hardly any phagocytic reaction from supporting cells, about half of which themselves succumbed. Cunningham says this could have clinical implications if dead hair cells then spill their cytoplasmic contents into the tissue, which can result in an immune response that can cause even further damage.

Distress call
Mark Warchol of Washington University in St. Louis says it will be important to identify the signal supporting cells are responding to after neomycin treatment. “There’s some molecular signal by which the hair cell causes [supporting cells] to execute this process. And with cisplatin, they’re just not capable of doing it.”

Tags

utriclesensory biologyphagocytosishearinghair cellearcell death and cell & molecular biology

20.  Inner Ear Cartography

Scientists map the position of cells within the organ of Corti.

By Ruth Williams | September 1, 2015

http://www.the-scientist.com//?articles.view/articleNo/43804/title/Inner-Ear-Cartography/

Age-related hearing loss caused by damage to the sensory hair cells within the cochlea is extremely common, but studying the inner ear is tough. “It’s in the densest bone in the body, so you don’t have access,” says John Brigande of Oregon Health and Science University in Portland. Even if you can extract cells, he says, “there are so darn few of them.”

Despite these technical difficulties, researchers have gleaned gene-expression information about different cell types within the organ of Corti—home to the sensory cells within the cochlea. But “it’s not only important to know what a cell expresses,” says Robert Durruthy-Durruthy, a postdoc in the Stanford University lab of Stefan Heller. “It’s also important to know where it can be found within a tissue.”

To this end, Durruthy-Durruthy, Heller, and postdoc Jörg Waldhaus have derived a 2-D map of organ of Corti cells from neonatal mice. First, the team sorted all cell types across the medial-to-lateral axis (or width) of the organ based on marker gene expression. The approximately 900 sorted cells, representing nine cell types, were then each quantitatively analyzed for the expression of 192 selected genes. Computational analysis of these expression data then enabled reconstruction of the cells’ positions along the organ’s apical-to-basal (length) and medial-to-lateral axes. In principle, the technique, which harnesses gene-expression information to determine cells’ spatial organization, could be applied to generate 2-D maps of any complex tissue, says Durruthy-Durruthy.

Within the mammalian cochlea, apical cells retain regenerative capacity for a few weeks after birth, but basal cells do not. “Spatial mapping allows us to get at the differences [between these cells],” says Brigande, and that could ultimately highlight possible ways to reinstate regeneration in the adult ear. (Cell Reports, 11:1385-99, 2015)

  FROM ORGAN TO SINGLE CELLS: To build a map of cells within the organ of Corti—where sound is translated to neural activity—scientists divide the cochlea in two. Each half of the organ of Corti is then broken up into its constituent cells, which comprise nine cell types (represented by the nine colors) spanning the organ’s edial-to-lateral axis.

http://www.the-scientist.com/images/August2015/MO_11.jpg

21.  Resveratrol Stabilizes Amyloid in Alzheimer’s

Pauline Anderson

September 17, 2015

http://www.medscape.com/viewarticle/851172?

High doses of purified resveratrol, a polyphenol found in some foods, appear to stabilize levels of amyloid beta (Aβ) in cerebrovascular fluid (CSF) and in plasma in patients with mild to moderate Alzheimer disease (AD) and are safe and well tolerated, a new phase 2 study has shown.

Although it is too soon to start recommending resveratrol supplements to patients, the research indicates that this compound is safe and is promising, lead author R. Scott Turner, MD, PhD, professor, Neurology, and director of the Memory Disorders Program, Georgetown University Medical Center, Washington, DC, one of 21 medical centers across the United States participating in the study.

“It seems to have some interesting effects, enough to justify further research into this strategy,” he told Medscape Medical News.

The study was published online September 11 as an Open Access article in Neurology.

Natural Compound

Resveratrol is a naturally occurring compound found in red grapes, red wine, dark chocolate, and some other foods, and is widely available as a supplement.

It is believed that resveratrol promotes resilience to stress, as levels increase in plants exposed to severe cold or to fungus, said Dr Turner. Animal research suggests that resveratrol may affect sirtuins, which are proteins that are activated with calorie restriction, which is a form of mild stress.

The study included 119 patients randomly assigned to either high doses of pure synthetic pharmaceutical grade resveratrol that is not available commercially (n = 64) or placebo (n = 55). The resveratrol used in the study was introduced at a dose of 500 mg a day and was increased every 3 months, so that by the end of the 1-year study, subjects were taking 2000 mg a day.

Results showed that at 1 year, the treated group’s levels of Aβ40 in CSF declined from 6574 to 6513 ng/mL, but in the placebo group, these levels went from 6560 to 5622 ng/mL, for a statistical difference at week 52 (P = .002).

This difference was also found in secondary analyses of study completers, in the mild dementia subgroup, and in APOE4 carriers and noncarriers.

The treated group’s Aβ40 levels in plasma declined from 163 to 153 ng/mL, and in the placebo group, these levels went from 165 to 132 ng/mL (for a statistical difference; P = .024).

“We can’t prove efficacy from this trial, but we’re looking for some movement in biomarkers, and we actually found that,” which is promising, said Dr Turner. “The major movement we found was in amyloid proteins in blood and CSF that were stabilized by resveratrol treatment compared to placebo, where it trended downhill, which is what happens with Alzheimer’s disease.”

This downhill trend could signal more amyloid being deposited into the brain. In contrast, that resveratrol seemed to stabilize Aβ40 in the CSF and plasma suggests the drug was able to penetrate the blood–brain barrier.

Unfortunately, said Dr Turner, the study could not fund amyloid positron emission tomography scans, which might have shed more light on the Aβ status of subjects.

Although there were no significant effects of the treatment on other amyloid biomarkers, including CSF and plasma Aβ42, trends were similar to the findings with Aβ40.

There was no difference in CSF tau. There was a trend toward an increase in CSF phospho-tau 181 with treatment (P = .08) and in secondary analysis of mild dementia (P = .047).

As for brain volume determined through magnetic resonance imaging (MRI), results showed that volumes declined more in the treatment group (going from 866 to 839 mL) than in the placebo group (going from 850 to 840 mL). This result was “mysterious” and “unexpected,” said Dr Turner.

However, he noted that the same effect has been reported in other AD trials, including those investigating immunotherapy. “The working hypothesis is that by treating AD, we are also decreasing the amount of inflammation and swelling in the brain.”

The study showed no significant effects on the mini mental state exam or on other clinical scales, but the researchers note that the phase 2 trial was not powered to detect differences in clinical outcomes.

However, they did find that the activities of daily living scale declined less in the resveratrol group than in the placebo group. “That’s also promising, because even with this phase 2, we are seeing what we think might be a clinical benefit,” said Dr Turner

A total of 657 adverse events were reported (355 in the treatment and 302 in the placebo groups), most of which were mild. The most common adverse events were gastrointestinal-related and included nausea and diarrhea.

Weight Loss

The placebo group gained about 1 pound of body weight, whereas the treated group lost almost 2 pounds. At the end of the study, the mean body mass index in the placebo group was 26.1, and in the treated group, it was 25.4.

“The weight loss is concerning, because Alzheimer disease itself causes weight loss, and we don’t want people to continue to lose weight,” said Dr Turner.

It is not clear whether the weight loss was a result of the adverse effects of diarrhea, nausea, and so on, or because of some metabolic effect.

Interestingly, six of the seven new neoplasms seen in study participants occurred in those taking placebo. This is of great interest to cancer researchers, said Dr Turner, adding that resveratrol and similar compounds are being tested in many age-related disorders, including diabetes and neurodegenerative disorders, as well as AD and cancer.

None of the 36 serious adverse events (19 on the drug and 17 on placebo), including three deaths, were deemed to be related to treatment.

Commenting on this study for Medscape Medical News, James Hendrix, PhD, director, Global Science Initiatives, Alzheimer’s Association, said that although the finding that resveratrol might stabilize Aβ40 is encouraging, the study needs to be followed up with a larger and longer phase 3 trial.

“The main focus of this study, and the main question it addressed, was whether a dose at such a high level is safe, and with the exception of some [gastrointestinal] discomfort for some people, it appears to be mostly safe.”

Dr Hendrix noted that the high dose used in the study is equivalent to 1000 bottles of red wine.

He pointed out that the study was relatively small, with 56 subjects completing the study in the treatment group, and only 48 in the placebo group.

The research was supported by a grant from the National Institute on Aging. Dr Turner reports no personal financial interests related to the study. Dr Hendrix is an employee of the Alzheimer’s Association, which has funded resveratrol grants in the past, but did not fund this study.

Neurology. Published online September 11, 2015. Full text

http://www.neurology.org/content/early/2015/09/11/WNL.0000000000002035.full.pdf

A randomized, double-blind, placebo-controlled trial of resveratrol for Alzheimer disease ABSTRACT Objective: A randomized, placebo-controlled, double-blind, multicenter 52-week phase 2 trial of resveratrol in individuals with mild to moderate Alzheimer disease (AD) examined its safety and tolerability and effects on biomarker (plasma Ab40 and Ab42, CSF Ab40, Ab42, tau, and phospho-tau 181) and volumetric MRI outcomes (primary outcomes) and clinical outcomes (secondary outcomes). Methods: Participants (n 5 119) were randomized to placebo or resveratrol 500 mg orally once daily (with dose escalation by 500-mg increments every 13 weeks, ending with 1,000 mg twice daily). Brain MRI and CSF collection were performed at baseline and after completion of treatment. Detailed pharmacokinetics were performed on a subset (n 5 15) at baseline and weeks 13, 26, 39, and 52. Results: Resveratrol and its major metabolites were measurable in plasma and CSF. The most common adverse events were nausea, diarrhea, and weight loss. CSF Ab40 and plasma Ab40 levels declined more in the placebo group than the resveratrol-treated group, resulting in a significant difference at week 52. Brain volume loss was increased by resveratrol treatment compared to placebo. Conclusions: Resveratrol was safe and well-tolerated. Resveratrol and its major metabolites penetrated the blood–brain barrier to have CNS effects. Further studies are required to interpret the biomarker changes associated with resveratrol treatment. Classification of evidence: This study provides Class II evidence that for patients with AD resveratrol is safe, well-tolerated, and alters some AD biomarker trajectories. The study is rated Class II because more than 2 primary outcomes were designated. Neurology® 2015;85:1–9

Caloric restriction prevents aging-dependent phenotypes1 and activates sirtuins (including SIRT1), a highly conserved family of deacetylases that are regulated by NAD1/NADH and thus link energy metabolism to gene expression.2 SIRT1 substrates include FOXO and PGC- 1a. 3 A screen of SIRT1 activators identified resveratrol (trans-3,49,5-trihydroxystilbene) as a potent compound.4 Similar to caloric restriction,5,6 resveratrol decreases aging-dependent cognitive decline and pathology in Alzheimer disease (AD) animal models.7,8

Resveratrol is under investigation to prevent age-related disorders including cancer, diabetes mellitus, and neurodegeneration.4,9–12 Due to its low bioavailability but high bioactivity,13,14 we increased the dose to the maximal amount considered safe and well-tolerated for this study.15 We conducted a randomized, placebocontrolled, double-blind, multicenter 52- week phase 2 trial of resveratrol in individuals with mild to moderate AD. The primary objectives were to (1) assess the safety and tolerability of resveratrol; (2) assess effect on plasma and CSF Ab42 and Ab40, CSF tau and phospho-tau 181, and volumetric MRI; and (3) examine pharmacokinetics. The secondary objectives were to (1) explore the effects of resveratrol on cognitive, functional, and behavioral outcomes; (2) examine the influence of APOE genotype; and (3) determine whether resveratrol affects insulin and glucose metabolism. We hypothesized that resveratrol would alter AD biomarker trajectories.

RESULTS A total of 179 participants were screened, of whom 60 were not randomized (50 screen-failed and 10 withdrew consent). Participants (119) were randomized as shown (figure 1). A total of 104 completed the study (12.6% dropout), and 77 completed 2 CSF collections (34% dropout). Eighteen participants discontinued treatment early and 15 discontinued the study. The population was English-speaking, 57% female, and 91% Caucasian.

Safety and tolerability. No differences between the resveratrol and placebo-treated groups were found on vital signs, physical examinations, or neurologic examinations. Routine laboratory tests were normal. A total of 657 AEs (490 mild, 139 moderate, 28 severe) were reported (355 on drug, 302 on placebo) (table 2). A total of 113 out of 119 (95%) participants reported at least 1 AE. The most common AEs were nausea and diarrhea (in 42% of individuals with drug vs 33% with placebo, p 5 0.35). Few participants reported nausea and diarrhea—the most likely drug-related AE—that led to treatment discontinuation, a treatment plateau at a lower dosage, or study discontinuation (figure 1). The placebo group gained 0.54 6 3.2 kg body weight, while the treated group lost 0.92 6 4.9 kg (mean 6 SD, p 5 0.038) resulting in a difference in body mass index (BMI). The treated group’s BMI was 25.4 6 4.0 vs the placebo group’s 26.1 6 4.1 at week 52 (mean 6 SD, p 5 0.047). Thirty-six serious AEs (SAEs) were reported (19 on drug, 17 on placebo) including 27 hospitalizations (14 on drug, 13 on placebo) and 3 deaths (1 on drug, 2 on placebo)—none study drug-related. There were no differences in participants who experienced at least one SAE (20.3% on drug, 18.2% on placebo), at least one hospitalization (18.8% drug, 16.4% placebo), or died (1.6% drug, 3.6% placebo). Seven new neoplasms were reported (1 on drug, 6 on placebo, p , 0.048) (table 2). Retrospective review of the brain MRIs of a placebo-enrolled participant with malignant glioma, which resulted in death, revealed that the tumor was present at screening. Two participant deaths were due to lung melanoma (placebo group) and drowning (drug group).

AD duration (from year of symptom onset), y, mean (SD)      Resv 3.9 (2.3)        Placebo 5.5 (2.6)     <0.001

Outcomes. At week 52, the treated group’s CSF Ab40 declined from 6,574 6 2,346 to 6,513 6 2,279 ng/mL and from 6,560 6 2,190 to 5,622 6 1,736 ng/mL with placebo, resulting in a difference at week 52 (mean 6 SD, p 5 0.002) (figure 2A). This difference was also found in secondary analyses of study completers (p 5 0.002), in the mild dementia subgroup (p 5 0.01), and in APOE4 carriers (p 5 0.05) and noncarriers (p 5 0.01) (table e-2). During the study, the treated group’s plasma Ab40 (figure 2B) declined from 163 6 58 to 153 6 54 ng/mL and from 165 6 55 to 132 6 54 ng/mL with placebo (mean 6 SD, p 5 0.024). Secondary analyses by APOE4 genotype revealed an effect of treatment on plasma Ab40 in APOE4 carriers (p 5 0.04) but not noncarriers (table e-2). There were no effects on CSF Ab42 or plasma Ab42 (figure 2, C and D), although trends were similar to Ab40. There was no difference in CSF tau and a trend toward an increase in CSF phospho-tau 181 with treatment (p 5 0.08), and in a secondary analysis of mild dementia (p 5 0.047) (data not shown). Volumetric MRIs revealed that brain volume (excluding CSF, brainstem, and cerebellum) declined more in the treatment group (p 5 0.025) with an increase in ventricular volume (p 5 0.05) at week 52 (figure 3, A and B). In the treatment group, brain volume decreased from 866 6 84 to 839 6 85 mL and ventricular volume increased from 55 6 24 to 81 6 24 mL (mean 6 SD). With placebo, brain volume decreased from 850 6 99 to 840 6 93 mL and ventricular volume increased from 56 6 19 to 76 6 25 mL (mean 6 SD). Secondary analyses revealed that brain volume declined with treatment in APOE4 carriers (p 5 0.02) but not noncarriers (table e-2). Similar results were found with ventricular volume, which increased with treatment in APOE4 carriers (p 5 0.05) but not noncarriers. This phase 2 trial (underpowered to detect differences in clinical outcomes) found no significant effects on CDR-SOB, ADAS-cog, MMSE, or NPI. The drugtreated group’s ADCS-ADL declined from 63.7 6 10.8 to 57.4 6 12.3 and from 60.5 6 10.7 to 51.3 6 14.5 in the placebo group (mean 6 SD, p 5 0.03), indicating less decline with treatment. No drug effects were found with plasma glucose or insulin metabolism (data not shown). We also analyzed (post hoc) the subset of individuals with CSF Ab42 ,600 ng/mL at baseline as a proxy of AD amyloid pathology. At week 52, differences between treatment groups persisted for CSF Ab40 (p 5 0.001, total n 5 70) and plasma Ab40 (p 5 0.02, n 5 83). In this analysis, we also found a treatment effect on CSF Ab42 (p 5 0.02, n 5 70) but lost significance in brain volume loss (p 5 0.06, n 5 83) and ADCSADL (p 5 0.055, n 5 88).

DISCUSSION High-dose oral resveratrol is safe and well-tolerated. The most common AEs were nausea and diarrhea, but results were similar to placebo. Weight and fat loss with resveratrol are reported in some preclinical studies,4 but human studies are scarce and of shorter duration. A decrease in body fat and a trend toward weight loss were reported in a 26- week trial with 200 mg/day resveratrol in healthy older participants.33 Weight and fat loss may be related to enhanced mitochondrial biogenesis mediated by SIRT1 activation of PCG-1a. 4,10,11 Ab levels declined as dementia advanced. The altered CSF Ab40 trajectory suggests that the drug penetrated the blood–brain barrier to have central effects. At week 52, the mean CSF levels of resveratrol, 3G-RES, 4G-RES, and S-RES were 3.3%, 0.4%, 0.4%, and 0.3%, respectively, of plasma levels at the same study visit. At the highest dosage, low mM levels of resveratrol and its metabolites were measured in plasma, with corresponding low nM levels found in CSF. Resveratrol has many targets, with some engaged at uM concentrations.4 These findings suggest that a central molecular target may be engaged at nM concentrations. In addition to anti-inflammatory, antioxidant, and anti-Ab aggregation, putative targets include sirtuin activation with enhanced a-cleavage of amyloid precursor protein34 and promotion of autophagy.35 Further studies of banked CSF, plasma, pellets, DNA, and blood mononuclear cells from participants will examine mechanisms.

Resveratrol treatment increased brain volume loss. This finding persisted when participants with weight loss (table 2) were excluded (data not shown). The etiology and interpretation of brain volume loss observed here and in other studies are unclear, but they are not associated with cognitive or functional decline. In the first human active Ab immunization trial, antibody responders had greater brain volume loss, and greater volumetric changes were associated with higher antibody titers.36 In the phase 2 bapineuzumab trial, treatment resulted in greater ventricular enlargement, but only in APOE4 carriers.37 In the phase 3 bapineuzumab APOE4 carrier trial and the high-dose noncarrier study, treatment resulted in a trend toward greater brain atrophy.38 Since this phase 2 study lacks consistent changes in clinical outcomes, interpretation of the effects on trajectories for plasma and CSF Ab40, and brain and ventricular volume, remain uncertain.

Resveratrol altered levels of CSF Ab40 (A) and plasma Ab40 (B) (ng/mL, mean 6 SE). Similar but nonsignificant trends were found for CSF Ab42 (C) and plasma Ab42 (D) (ng/mL, mean 6 SE). Note difference in scales. Sample sizes are indicated.

Resveratrol increased brain volume loss (A, C) (mL, mean 6 SE) with a corresponding increase in ventricular volume (B, D) (mL, mean 6 SE). Sample sizes are indicated.

This phase 2 study has limitations. It was designed to determine the safety and tolerability of resveratrol and to examine pharmacokinetics. Although some biomarker trajectories were altered, we found no effects of drug treatment on plasma Ab42, CSF Ab42, CSF tau, CSF phospho-tau 181, hippocampal volume, entorhinal cortex thickness, MMSE, CDR, ADAS-cog, NPI, or glucose or insulin metabolism. The altered biomarker trajectories must be interpreted with caution. Although they suggest CNS effects, they do not indicate benefit.

22.  Miniature VHS Solenoid Valves Play Significant Role in the Viability of 3D Bio-Printing of Human Cells  

The rapid development of viable inkjet technology for highly specialised applications, such as printing human cells, continues to generate significant interest. If successful, the realisation of this technology for specialised biological applications, generally known as ‘biofabrication’, has the potential to replace the long established (and often controversial) process of using animals for testing new drugs. However, there are many challenges to overcome to enable the successful production of a valve-based cell printer for the formation of human embryonic stem cell spheroid aggregates. For example, printing techniques need to be developed which are both controllable and less harmful to the process of preserving human cell tissue viability and functions.

One particular cell printing project at an advanced stage and which has benefitted from the features and benefits of Lee Products miniature VHS solenoid valves and nozzles, is the result of pioneering activities at Edinburgh’s Heriot-Watt University. Dr Will Shu at the University’s Biomedical micro-engineering Group and his colleagues, including Alan Faulkner-Jones a bioengineering PhD student have successfully developed a bio-printer which has been demonstrated at the 3D Print show in London. Also involved in the development of the bio-printer are specialists at Roslin Cellab in Midlothian, a leading stem cell technology company.

The valve based bio-printer has been validated to print highly viable cells in programmable patterns from two different bio-inks with independent control of the volume of each droplet (with a lower limit of 2nL or fewer than five cells per droplet). Human ESC’s (Embryonic Stem Cells) were used to make spheroids by overprinting two opposing gradients of bio-ink; one of hESC’s in medium and the other of medium alone.
The resulting array of uniform sized droplets with a gradient of cell concentrations was inverted to allow cells to aggregate and form spheroids via gravity.
The resulting aggregates have controllable and repeatable sizes and consequently they can be made to order for specific applications. Spheroids with between 5 and 140 dissociated cells resulted in spheroids of 0.25-0.6 mm diameter. The success of the bio-printer demonstrates that a valve based printing process is gentle enough to maintain stem cell viability, accurate enough to produce spheroids of uniform size and that printed cells maintain their pluripotency.
Looking closer at the design of the bio-printer platform reveals two dispensing systems, each comprising a Lee VHS Nanolitre solenoid dispensing valve with a Teflon coated 101.6 µm internal diameter Lee Minstac nozzle controlled by a Arduino microcontroller. Each dispensing system is attached to a static pressure reservoir for the bio-ink solution to be dispensed via flexible tubing. The dispensing system and bio-ink reservoirs are mounted within a custom-built enclosure on the tool head of a micrometer-resolution 3-axis 3d printing platform (High-Z S-400, CNC Step) and controlled by a customized CNC controller (based on G540, Geokodrives).

A relatively larger nozzle diameter (compared to the size of the cells that are printed) was selected to reduce the amount of shear stress that could be experienced by the cells during the dispensing process. The bio-ink reservoirs were kept as close as possible to the valves in order to minimise the amount of time it would take to charge the system with bio-ink and to purge it at the end of the experiment. A USB microscope is also included to enable visual inspection of the target substrate during the printing process. Due to the type of deposition system used, a direct line of sight view through the nozzle is not possible and therefore the USB microscope is mounted at an offset angle from the cell deposition system assemblies.
Commenting on the development of the bio-printer and the vital role played by Lee Product’s VHS solenoid valves, Dr Will Shu at Heriot-Watt University said: “Printing living cells is extremely challenging and to the best of our knowledge, this is the first time that these cells have been 3D printed. The technique will allow us to create more accurate human tissue models which are essential to in-vitro drug development and toxicity testing and since the majority of drug discovery is targeting human disease, it makes sense to use human tissues.
”The development of the bio-printer has taken many years of effort and we are very pleased with the performance of Lee’s VHS solenoid valves, they are a vital component within the bio-printer printhead and we recommend them to our colleagues working on similar projects.”
Dr Shu added, “We also acknowledge the support and interaction from our contacts at Lee Products which has helped us to overcome the challenges of this project.”
This highly specialised application is an excellent example of the performance of Lee’s range of VHS Micro-Dispense Solenoid Valves which provide precise, repeatable, non-contact dispensing of fluids in the nanolitre to microlitre range. The valves feature a number of port configurations to facilitate quick and convenient connections to Lee’s 062 MINSTAC fittings and press-on tubing. The 062 MINSTAC outlet port can be used with Lee 062 MINSTAC tubing or atomising nozzles. Custom configurations and voltages are also available to suit specific applications.

https://www.labmate-online.com/articles/laboratory-products/3/dr_will_shu_and_alan_faulkner-jones/miniature_vhs_solenoid_valves_play_significant_role_in_the_viability_of_3d_bio-printing_of_human_cells_/1833/#sthash.IbWGZ7fU.Maild7vy.dpuf

23. NEW MITOCHONDRIA-BASED INSULIN AMPLIFIER PATHWAY IDENTIFIED IN T2 DIABETES.

http://health-innovations.org/2015/09/23/new-mitochondria-based-insulin-amplifier-pathway-identified-in-t2-diabetes/

Posted on September 23, 2015 by Healthinnovations

Ten million Canadians are living with diabetes or pre-diabetes. The Canadian Diabetes Association reports that more than 20 Canadians are newly diagnosed with the disease every hour of every day. It is also the seventh leading cause of death in Canada, with associated health-care costs estimated at nearly $9 billion a year. Type 2 diabetes accounts for 90 per cent of all cases, increasing the risk of blindness, nerve damage, stroke, heart disease and several other serious health conditions.

Insulin secretion from β cells of the pancreatic islets of Langerhans is impaired in type 2 diabetes (T2D).  Evidence suggests that this metabolic amplification of insulin secretion occurs distally in the secretory pathway, possibly at the calcium dependent exocytotic site.  Therefore the regulation or amplification of insulin is an important target for researchers around the world

Now, researchers from the University of Alberta have identified a new molecular pathway that manages the amount of insulin produced by the pancreatic cells, essentially a ‘dimmer’ switch that adjusts how much or how little insulin is secreted when blood sugar increases.  The team state that the dimmer appears to be lost in Type 2 diabetes, however, it can be restored and ‘turned back on’, reviving proper control of insulin secretion from islet cells of people with Type 2 diabetes.  The opensource study is published in the Journal of Clinical Investigation.

Previous studies show that the canonical mechanism of glucose-stimulated insulin secretion involving increases in metabolism-derived ATP, inhibition of KATP channels, and activation of VDCCs was first introduced more than 30 years ago and remains as a cornerstone mechanism for the triggering of insulin secretion’.  The KATP channel mechanism does not define the entire secretory response with multiple metabolic coupling intermediates proposed as factors that amplify the secretory response to a Ca2+exocytosis-based signal, with the net export of mitochondrial substrates being of great interest.

The current study examined pancreatic islet cells from 99 human organ donors.  Results show that the glucose-dependent amplification of exocytosis in human β cells, which is disrupted in type 2 diabetes, requires isocitrate flux through mitochondrial export which generates cytosolic NADPH and GSH. These then act through SENP1 to amplify the exocytosis of insulin, thereby controlling glucose homeostasis.  The lab then validated these data findings in a transgenic animal model.

The researchers state that the discovery is a potential game-changer in Type 2 diabetes research, leading to a new way of thinking about the disease and its future treatment.  The go on to add that understanding the islet cells in the pancreas that make insulin, how they work, and how they can fail, could lead to new ways to treat the disease, delaying or even preventing diabetes.

The team surmise that although the ability to restore and fix the dimmer switch in islet cells may have been proven on a molecular level, finding a way to translate those findings into clinical use could yet take decades. Despite this the group conclude that the findings show an important new way forward.

Source: University of Alberta

https://michellepetersen76.files.wordpress.com/2015/09/identifying-the-dimmer-switch-of-diabetes-healthinnovations.jpg?w=860

Pancreatic islet–specific knockout of Senp1 blunts insulin secretion due to an impaired amplification of exocytosis. Proposed pathway linking mitochondrial export of (iso)citrate, glutathione biosynthesis (blue), and glutathione reduction (orange) pathways to the amplification of insulin exocytosis (yellow). Isocitrate-to-SENP1 signaling amplifies insulin secretion and rescues dysfunctional β cells. MacDonald et al 2015.

24.  Nanotechnology
http://www.nano.gov/nanotech-101/what/definition

Nanotechnology is science, engineering, and technology conducted at the nanoscale, which is about 1 to 100 nanometers.

Physicist Richard Feynman, the father of nanotechnology.

Nanoscience and nanotechnology are the study and application of extremely small things and can be used across all the other science fields, such as chemistry, biology, physics, materials science, and engineering.

The ideas and concepts behind nanoscience and nanotechnology started with a talk entitled “There’s Plenty of Room at the Bottom” by physicist Richard Feynman at an American Physical Society meeting at the California Institute of Technology (CalTech) on December 29, 1959, long before the term nanotechnology was used. In his talk, Feynman described a process in which scientists would be able to manipulate and control individual atoms and molecules. Over a decade later, in his explorations of ultraprecision machining, Professor Norio Taniguchi coined the term nanotechnology. It wasn’t until 1981, with the development of the scanning tunneling microscope that could “see” individual atoms, that modern nanotechnology began.

Medieval stained glass windows are an example of  how nanotechnology was used in the pre-modern era. (Courtesy: NanoBioNet)

It’s hard to imagine just how small nanotechnology is. One nanometer is a billionth of a meter, or 10-9 of a meter. Here are a few illustrative examples:

  • There are 25,400,000 nanometers in an inch
  • A sheet of newspaper is about 100,000 nanometers thick
  • On a comparative scale, if a marble were a nanometer, then one meter would be the size of the Earth

Nanoscience and nanotechnology involve the ability to see and to control individual atoms and molecules. Everything on Earth is made up of atoms—the food we eat, the clothes we wear, the buildings and houses we live in, and our own bodies.

But something as small as an atom is impossible to see with the naked eye. In fact, it’s impossible to see with the microscopes typically used in a high school science classes. The microscopes needed to see things at the nanoscale were invented relatively recently—about 30 years ago.

Once scientists had the right tools, such as the scanning tunneling microscope (STM) and the atomic force microscope (AFM), the age of nanotechnology was born.

Although modern nanoscience and nanotechnology are quite new, nanoscale materials were used for centuries. Alternate-sized gold and silver particles created colors in the stained glass windows of medieval churches hundreds of years ago. The artists back then just didn’t know that the process they used to create these beautiful works of art actually led to changes in the composition of the materials they were working with.

Today’s scientists and engineers are finding a wide variety of ways to deliberately make materials at the nanoscale to take advantage of their enhanced properties such as higher strength, lighter weight, increased control of light spectrum, and greater chemical reactivity than their larger-scale counterparts.

http://www.nano.gov/node/1415

Education and workforce development are critical to the advancement of nanotechnology and are encompassed within one of the four goals of the National Nanotechnology Initiative (NNI): “Develop and sustain educational resources, a skilled workforce, and a dynamic infrastructure and toolset to advance nanotechnology.” As new knowledge is created through exploratory research and development, it is a challenge to translate this understanding into the educational system and to the broader public. Over the past fifteen years of the NNI, there have been several activities that have made significant contributions in this area: public outreach and informal education by the NSF Nanoscale Informal Science Education  Network (NISE Net) through programs such as NanoDays; technician and workforce training through programs such as the NSF Advanced Technological Education Centers including the Nanotechnology Applications and Career Knowledge (NACK) Network; countless university courses and degree programs; and the emerging incorporation of nanoscience into the K-12 science education standards in states such as Virginia. To build upon this strong foundation, several announcements were made last week at the White House Forum on Small Business Challenges to Commercializing Nanotechnology including the establishment of a Nano and Emerging Technologies Student Leaders conference, a webinar series focused on providing information for teachers, and a web portal of nanoscale science and engineering educational resources.  – See more at: http://www.nano.gov/node/1415#sthash.fw1tMPiU.dpuf

25.  Antimicrobial film for future implants

http://www.nanowerk.com/news2/biotech/newsid=41408.php

(Nanowerk News) The implantation of medical devices is not without risks. Bacterial or fungal infections can occur and the body’s strong immune response may lead to the rejection of the implant. Researchers at Unit 1121 “Biomaterials and Bio-engineering” (Inserm/Strasbourg university) have succeeded in creating a biofilm with antimicrobial, antifungal and anti-inflammatory properties. It may be used to cover titanium implants (orthopaedic prostheses, pacemakers…) prevent or control post-operative infections. Other frequently used medical devices that cause numerous infectious problems, such as catheters, may also benefit.
These results are published in the journal Advanced Healthcare Materials (“Harnessing the Multifunctionality in Nature: A Bioactive Agent Release System with Self-Antimicrobial and Immunomodulatory Properties”).

26.  Characterizing the forces that hold everything together: UMass Amherst physicists offer new open source calculations for molecular interactions

http://www.nanotech-now.com/news.cgi?story_id=52274

UMass Amherst physicists, with others, provide a new software tool and database to help materials designers with the difficult calculations needed to predict the magnitude of van der Waals interactions between anisotropic or directionally dependent bodies such as those illustrated, with long-range torques. Though small, these forces are dominant on the nanoscale.

CREDIT: UMass Amherst

Abstract:
As electronic, medical and molecular-level biological devices grow smaller and smaller, approaching the nanometer scale, the chemical engineers and materials scientists devising them often struggle to predict the magnitude of molecular interactions on that scale and whether new combinations of materials will assemble and function as designed.

Characterizing the forces that hold everything together: UMass Amherst physicists offer new open source calculations for molecular interactions

Amherst. MA | Posted on September 23rd, 2015

This is because the physics of interactions at these scales is difficult, say physicists at the University of Massachusetts Amherst, who with colleagues elsewhere this week unveil a project known as Gecko Hamaker, a new computational and modeling software tool plus an open science database to aid those who design nano-scale materials.

In the cover story in today’s issue of Langmuir, Adrian Parsegian, Gluckstern Chair in physics, physics doctoral student Jaime Hopkins and adjunct professor Rudolf Podgornik on the UMass Amherst team report calculations of van der Waals interactions between DNA, carbon nanotubes, proteins and various inorganic materials, with colleagues at Case Western Reserve University and the University of Missouri who make up the Gecko-Hamaker project team.

To oversimplify, van der Waals forces are the intermolecular attractions between atoms, molecules, surfaces, that control interactions at the molecular level. The Gecko Hamaker project makes available to its online users a large variety of calculations for nanometer-level interactions that help to predict molecular organization and evaluate whether new combinations of materials will actually stick together and work.

In this work supported by the U.S. Department of Energy, Parsegian and colleagues say their open-science software opens a whole range of insights into nano-scale interactions that materials scientists haven’t been able to access before.

Parsegian explains, “Van der Waals forces are small, but dominant on the nanoscale. We have created a bridge between deep physics and the world of new materials. All miniaturization, all micro- and nano-designs are governed by these forces and interactions, as is behavior of biological macromolecules such as proteins and lipid membranes. These relationships define the stability of materials.”

He adds, “People can try putting all kinds of new materials together. This new database and our calculations are going to be important to many different kinds of scientists interested in colloids, biomolecular engineering, those assembling molecular aggregates and working with virus-like nanoparticles, and to people working with membrane stability and stacking. It will be helpful in a broad range of other applications.”

Podgornik adds, “They need to know whether different molecules will stick together or not. It’s a complicated problem, so they try various tricks and different approaches.” One important contribution of Gecko Hamaker is that it includes experimental observations seemingly unrelated to the problem of interactions that help to evaluate the magnitude of van der Waals forces.

Podgornik explains, “Our work is fundamentally different from other approaches, as we don’t talk only about forces but also about torques. Our methodology allows us to address orientation, which is more difficult than simply describing van der Waals forces, because you have to add a lot more details to the calculations. It takes much more effort on the fundamental level to add in the orientational degrees of freedom.”

He points out that their methods also allow Gecko Hamaker to address non-isotropic, or non-spherical and other complex molecular shapes. “Many molecules don’t look like spheres, they look like rods. Certainly in that case, knowing only the forces isn’t enough. You must calculate how torque works on orientation. We bring the deeper theory and microscopic understanding to the problem. Van der Waals interactions are known in simple cases, but we’ve taken on the most difficult ones.”

Hopkins, the doctoral student, notes that as an open-science product, Gecko Hamaker’s calculations and data are transparent to users, and user feedback improves its quality and ease of use, while also verifying the reproducibility of the science.

####

For more information, please click here

Contacts:
Janet Lathrop
jlathrop@admin.umass.edu
413-545-0444

27.  Researchers have succeeded in creating a biofilm with antimicrobial, antifungal and anti-inflammatory properties. (Image: Inserm / E.Falett)
Implantable medical devices (prosthesis/pacemakers) are an ideal interface for micro-organisms, which can easily colonize their surface. As such, bacterial infection may occur and lead to an inflammatory reaction. This may cause the implant to be rejected. These infections are mainly caused by bacteria such as Staphylococcus aureus, originating in the body, and Pseudomonas aeruginosa. These infections may also be fungal or caused by yeasts. The challenge presented by implanting medical devices in the body is preventing the occurrence of these infections, which lead to an immune response that compromises the success of the implant. Antibiotics are currently used during surgery or to coat certain implants. However, the emergence of multi-resistant bacteria now restricts their effectiveness.
A biofilm invisible to the naked eye…
It is within this context that researchers at the “Bioengineering and Biomaterials” Unit 1121 (Inserm/Strasbourg University) with four laboratories1 have developed a biofilm with antimicrobial and anti-inflammatory properties. Researchers have used a combination of two substances: polyarginine (PAR) and hyaluronic acid (HA), to develop and create a film invisible to the naked eye (between 400 and 600 nm thick) that is made of several layers. As arginine is metabolised by immune cells to fight pathogens, it has been used to communicate with the immune system to obtain the desired anti-inflammatory effect. Hyaluronic acid, a natural component of the body, was also chosen for its biocompatibility and inhibiting effect on bacterial growth.
…with embedded antimicrobial peptides,
The film is also unique due to the fact that it embeds natural antimicrobial peptides, in particular catestatin, to prevent possible infection around the implant. This is an alternative to the antibiotics that are currently used. As well as having a significant antimicrobial role, these peptides are not toxic to the body that they are secreted into. They are capable of killing bacteria by creating holes in their cellular wall and preventing any counter-attack on their side.
…on a thin silver coating,
In this study researchers show that poly(arginine), associated with hyaluronic acid, possesses microbial activity against Staphylococcus aureus (S. aureus) for over 24 hours. “In order to prolong this activity, we have placed a silver-coated precursor before applying the film. Silver is an anti-infectious material currently used on catheters and dressings. This strategy allows us to extend antimicrobial activity in the long term” explains Philippe Lavalle, Research Director at Inserm.
…effectively reducing inflammation, preventing and controlling infection
The results from numerous tests performed on this new film shows that it reduces inflammation and prevents the most common bacterial and fungal infections.
On the one hand, researchers demonstrate, through contact with human blood, that the presence of the film on the implant suppresses the activation of inflammatory markers normally produced by immune cells in response to the implant. Moreover, “the film inhibits the growth and long-term proliferation of staphylococcal bacteria (Staphylococcus aureus), yeast strains (Candida albicans) or fungi (Aspegillus fumigatus) that frequently cause implant-related infection” emphasises Philippe Lavalle.
Researchers conclude that this film may be used in vivo on implants or medical devices within a few years to control the complex microenvironment surrounding implants and to protect the body from infection.
Source: INSERM (Institut national de la santé et de la recherche médicale)

28.  Quantum dots light up under strain

http://www.nanotech-now.com/news.cgi?story_id=52274

Semiconductor nanocrystals, or quantum dots, are tiny, nanometer-sized particles with the ability to absorb light and re-emit it with well-defined colors. With low-cost fabrication, long-term stability and a wide palette of colors, they have become a building blocks of the display technology, improving the image quality of TV-sets, tablets, and mobile phones. Exciting quantum dot applications are also emerging in the fields of green energy, optical sensing, and bio-imaging.

Prospects have become even more appealing after a publication, entitled “Band structure engineering via piezoelectric fields in strained anisotropic CdSe/CdS nanocrystals,” was published in the journal Nature Communications last July. An international team, formed by scientists at the Italian Institute of Technology (Italy), the University Jaume I (Spain), the IBM research lab Zurich (Switzerland) and the University of Milano-Bicocca (Italy) demonstrated a radically new approach to manipulate the light emission of quantum dots.

The traditional operating principle of quantum dots is based on the so-called quantum confinement effect, where the particle size determines the color of the emitted light. The new strategy relies on a completely different physical mechanism; a strain induced electrical field inside the quantum dots. It is created by growing a thick shell around the dots. This way, researchers were able to compress the inner core, creating the intense internal electric field. This field now becomes the dominating factor in determining the emission properties.

The result is a new generation of quantum dots whose properties are beyond those enabled by quantum confinement alone. This not only broadens the application scope of the well-known CdSe/CdS material set but also of other materials. “Our findings add an important new degree of freedom to the development of quantum dot-based technological devices,” the researchers say. “For example, the elapsed time between light absorption and emission can be extended to be more than 100 times longer compared to conventional quantum dots, which opens the way towards optical memories and smart pixel new devices. The new material could also lead to optical sensors that are highly sensitive to the electrical field in the environment on the nanometer scale.”

Explore further: Resonant energy transfer from quantum dots to graphene

More information: “Band structure engineering via piezoelectric fields in strained anisotropic CdSe/CdS nanocrystals” Nat Commun. 2015 Jul 29; 6:7905. DOI: 10.1038/ncomms8905

Journal reference: Nature Communications

Read more at: http://phys.org/news/2015-09-quantum-dots-strain.html#jCp

29. Turing Reaction-diffusion Model Confirmed

http://www.scientificcomputing.com/news/2015/09/turing-reaction-diffusion-model-confirmed?

http://www.scientificcomputing.com/sites/scientificcomputing.com/files/Turing_Reaction-diffusion_Model_Confirmed_ml.jpg

In 1952, the legendary British mathematician and cryptographer Alan Turing proposed a model, which assumes formation of complex patterns through chemical interaction of two diffusing reagents. Russian scientists managed to prove that the corneal surface nanopatterns in 23 insect orders completely fit into this model.

Their work is published in the Proceedings of the National Academy of Sciences.

The work was done by a team working in the Institute of Protein Research of the Russian Academy of Sciences, (Pushchino, Russia) and the Department of Entomology at the Faculty of Biology of the Lomonosov Moscow State University. It was supervised by Professor Vladimir Katanaev, who also leads a lab in the University of Lausanne, Switzerland. Artem Blagodatskiy and Mikhail Kryuchkov performed the choice and preparation of insect corneal samples and analyzed the data. Yulia Lopatina from the Lomonosov Moscow State University played the role of expert entomologist, while Anton Sergeev performed the atomic force microscopy.

The initial goal of the study was to characterize the antireflective three-dimensional nanopatterns covering insect eye cornea, with respect to the taxonomy of studied insects and to get insight into their possible evolution path.

The result was surprising as the pattern morphology did not correlate with insect position on the evolutionary tree. Instead, Russian scientists have characterized four main morphological corneal nanopatterns as well as transition forms between them, omnipresent among the insect class. Another finding was that all the possible forms of the patterns directly matched to the array of patterns predicted by the famous Turing reaction-diffusion model published in 1952, what Russian scientists confirmed not by mere observation, but by mathematical modeling as well. The model assumes formation of complex patterns through chemical interaction of two diffusing reagents.

The analysis of corneal surface nanopatterns in 23 insect orders has been performed by means of atomic force microscopy with resolution up to single nanometers.

“This method allowed us to drastically expand the previously available data, acquired through scanning electron microscopy; it also made possible to characterize surface patterns directly, not based upon analysis of metal replicas. When possible, we always examined corneae belonging to distinct families of one order to get insight into intra-order pattern diversity,” Blagodatskiy said.

The main implication of the work is the understanding of the mechanisms underlying the formation of biological three-dimensional nano-patterns, demonstrating the first example of Turing reaction-diffusion model acting in the bio-nanoworld.

Interestingly, the Turing nanopatterning mechanism is common not only for the insect class, but also for spiders, scorpions and centipedes in other words — universal for arthropods. Due to the antireflective properties of insect corneal nanocoatings, the revealed mechanisms are paving the way for design of artificial antireflective nanosurfaces.

“A promising future development of the project is planned to be a genetic analysis of corneal nanopattern formation on platform of a well-studied Drosophila melanogaster (fruitfly) model. The wild-type fruitflies possess a nipple array type nanocoating on their eyes,” Blagodatskiy summarized.

Different combinations of overexpressed and underexpressed proteins known to be responsible for corneal development in Drosophila may alter the nipple pattern to another pattern type and thus shed the light on chemical nature of compounds, forming the Turing-type structures upon insect eyes. Revealing of proteins and\or other agents responsible for nanopattern formation will be a direct clue to artificial design of nanocoatings with desired properties. Another direction of project development will be the comparison

Citation: Artem Blagodatski, Anton Sergeev, Mikhail Kryuchkov, Yuliya Lopatina, Vladimir L. Katanaev. Diverse set of Turing nanopatterns coat corneae across insect lineages.Proceedings of the National Academy of Sciences, 2015; 112 (34): 10750 DOI:10.1073/pnas.1505748112

30.  Germ-free mice gain weight when transplanted with gut microbes from obese humans, in a diet-dependent manner.

By Ed Yong | September 5, 2013

Escherichia coliWIKIPEDIAPhysical traits like obesity and leanness can be “transmitted” to mice, by inoculating the rodents with human gut microbes. A team of scientists led byJeffrey Gordon from the Washington University School of Medicine in St. Louis found that germ-free mice put on weight when they were transplanted with gut microbes from an obese person, but not those from a lean person.

The team also showed that a “lean” microbial community could infiltrate and displace an “obese” one, preventing mice from gaining weight so long as they were on a healthy diet. The results were published today (September 5) in Science.

Gordon emphasized that there are many causes of obesity beyond microbes. Still, he said that studies like these “provide a proof-of-principle for ameliorating diseases.” By understanding how microbes and food interact to influence human health, researchers may be able to design effective probiotics that can prevent obesity by manipulating the microbiome.

The human gut is home to tens of trillions of microbes, which play crucial roles in breaking down food and influencing health. Gordon’s group and others have now shown that obese and lean people differ in their microbial communities. Just last week, the MetaHIT consortium showed that a quarter of Danish people studied had a very low number of bacterial genes in their gut—an impoverished state that correlated with higher risks of both obesity and metabolic diseases.

However, descriptive studies like these cannot tell scientists whether such microbial differences are the cause of obesity or a consequence of it. “A lot of correlations are being made between microbe community configurations and disease states, but we don’t know if these are casual or causal,” said Gordon. By using germ-free mice as living laboratories, Gordon and his colleagues aim to start moving “beyond careful description to direct tests of function,” he added.

“It’s extremely exciting and powerful to go from descriptive studies in humans to mechanistic studies in mice,” said Oluf Pedersen, an endocrinologist who was involved in the MetaHIT studies. “That’s beautifully illustrated in this paper.”

Gordon lab graduate student Vanessa Ridaura inoculated the germ-free mice with gut microbes from four pairs of female twins, each in which one person was obese and the other had a healthy weight. Mice that received the obese humans’ microbes gained more body fat, put on more weight, and showed stronger molecular signs of metabolic problems.

Once the transplanted microbes had taken hold in their guts, but before their bodies had started to change, Ridaura housed the two groups of mice together. Mice regularly eat one another’s feces, so these cage-mates inadvertently introduced their neighbors’ microbes to their own gut communities. Gordon called this the “Battle of the Microbiota.”

These co-housing experiments prevented the mice with “obese” microbes from putting on weight or developing metabolic problems, while those with the “lean” microbes remained at a healthy weight.

Gordon explains that the obese microbe communities, being less diverse than the lean ones, leave many “job openings” within the gut—niches that can be filled by the diverse lean microbes when they invade. “And obviously, those job openings aren’t there in the richer, lean gut community,” he said. “That’s why the invasion is one-directional.”

“But if invasion is so robust, why then isn’t there an epidemic of leanness?” asked Gordon. “The answer appears to be, in part, diet.”

In her initial experiments, Ridaura fed the mice standard chow, which is high in fiber and plant matter. She also blended up two new recipes, designed to reflect extremes of saturated fat versus fruit and vegetable consumption associated with Western diets.

If the mice were fed food low in fat and high in fruit and vegetables, Ridaura found the same results as before—the lean microbes could cancel out the effect of the obese ones. But when the mice were fed food low in fruit and vegetables and high in saturated fat, those with obese gut microbes still gained weight, no matter who their neighbors were.

This may be because the best colonizers among the lean communities were the Bacteroidetes—a group of bacteria that are excellent at breaking down the complex carbohydrates found in plant foods. When the mice ate plant-rich diets, the Bacteroidetes could fulfill a metabolic role that was vacant in the obese gut communities. When the mice ate unhealthy, plant-poor diets, “these vacancies weren’t there and the organisms couldn’t establish themselves,” said Gordon.

“We’re now trying to identify particular sets of organisms that can do what the complete community does,” Gordon added. The ultimate goal is to create a set of specific bacteria that could be safely administered as a probiotic that, along with a defined diet, could help these beneficial microbes to establish themselves and might effectively prevent weight gain.

“This study is an inspiration for us at MetaHIT,” said Pedersen. “It would be very interesting to take stools or cultures from extreme cases within our samples—people who have very rich or very poor gut microbiomes—and inoculate them into germ-free mice. . . . Now that we have a proof-of-concept, it’s obvious for us to follow up our findings through these studies.”

V.K. Ridaura et al., “Gut microbiota from twins discordant for obesity modulate metabolism in mice,” Science, doi: 10.1126/science.1241214, 2013.

31. Gut Microbes Treat Illness

Oral administration of a cocktail of bacteria derived from the human gut reduces colitis and allergy-invoked diarrhea in mice.

By Chris Palmer | July 10, 2013

Micrograph of germ-free mice colon colonized with 17 strains of human-derived Clostridia. Kenya Honda

An astounding array of microorganisms colonizes the human gut; our large intestines alone are home to 1014 bacteria from more than 1,000 species. Though scientists have long attempted to manipulate these microbial populations to affect health, probiotics have failed to reliably treat disease. However, a new study published today in Nature reports that a blend of specially selected strains of Clostridium bacteria derived from humans can significantly reduce symptoms of certain immune disorders in mice.

“[This work] shows that microbes can influence the balance and architecture of the immune system of their host,” said Sarkis Mazmanian, an immunologist at the California Institute of Technology who did not participate in the research. “I think it has tremendous potential for ameliorating human disease.”

Mammalian gut microbiota—the community of microorganisms that inhabit the gastrointestinal tract—have a long, intimate, and mostly symbiotic history with their hosts. The ubiquitous bugs are integral to some of the most basic of physiological functions, including metabolism and immune system development and function. However, specific gut microbes have also been linked to autoimmune disorders, obesity, inflammatory bowel disease, and possibly even neurological disorders. “It’s clear that gut microbes can affect many, many aspects of our physiology,” said Mazmanian.

Senior author Kenya Honda and his team previously reported that colonization of germ-free mice—mice that lack a microbiota—with a cocktail of a few dozen strains of Clostridium bacteria derived from wild-type mice promoted the activity of regulatory T cells (Treg) in the colon. Treg cells produce important anti-inflammatory immune molecules, including interleukin-10 and inducible T-cell co-stimulator, to prevent an overreaction of the immune system, and disruption of Treg cells is known to play a role in autoimmune disorders such as colitis, Crohn’s disease, food allergies, and type II diabetes. Indeed, mice treated with theClostridium cocktail appeared more resistant to allergies and intestinal inflammation.

Clostridia bacteria include the well-known tetanus and botulism toxins. “Clostridia are very diverse bacteria, and include some pathogens,” said Alexander Rudensky, an immunologist at the Memorial Sloan-Kettering Cancer Center in New York and a cofounder,  of Vedanta Biosciences, which he launched with the paper authors in 2010. “So, their role [in disease] may be surprising to immunologists and public, but not to microbiologists.”

To extend the clinical relevance of the previous results, Honda’s group repeated their experiment usingClostridium derived from a sample of human feces. As in the previous study, germ-free mice treated with specially selected strains of human-derived Clostridia displayed a significant increase in Treg cells. The treated mice also displayed reduced symptoms of colitis and allergy-induced diarrhea.

“This is a terrific advance to their previous studies where they showed that mouse microbiota can induce regulatory T cells,” said Mazmanian. “In this paper they’ve extended that to bacteria that come from humans, which they have tested in mice.”

The researchers used RNA sequencing of gut tissue samples of mice treated with human microbes to identify 17 specific non-virulent strains of Clostridium responsible for the increased production of Treg cells. They then sequenced the metagenomes of human ulcerative colitis patient guts, and found that they tended to carry lower levels of the 17 strains, with 5 out of the 17 showing a statistically significant reduction. “This work lays out the first instance of a rationally designed drug candidate isolated from human microbiota, which can be given to animals to treat autoimmune disease,” said study coauthor Bernat Olle, the chief operating officer of Vedanta Biosciences, which is developing therapies based on the new research.

Investigations into the mechanisms underlying Treg-cell induction pointed to small chain fatty acids and bacterial antigens that are cooperatively produced by the 17 strains of Clostridium. The small chain fatty acids and antigens in turn activate a transforming growth factor (TGF-beta) response that drives Treg cell differentiation and expansion.

“It’s very valuable to see studies like this one, where detailed analysis of microbial compositions is linked to biology,” said Rudensky.

Atarashi et al., “Treg induction by a rationally selected mixture of Clostridia strains from the human microbiota,” Nature, doi:10.1038/nature12331, 2013.

 

32.  Foxp3 targets revealed

The first comprehensive — but preliminary — list of Foxp3 targets in mice could provide clues to how the protein helps regulate the immune system

By Chandra Shekhar | January 22, 2007

The first comprehensive catalogue of mouse genes targeted by the transcriptional factor Foxp3 appears intwo papers published in this week’s Nature. The lists from both studies don’t always match, but the combined findings represent a key step in understanding how the protein helps regulatory T-cells maintain immune system tolerance and prevent autoimmune diseases. “The papers provide the first look at relating the transcriptional DNA-binding activity of Foxp3 with specific target genes,” said Fred Ramsdell of ZymoGenetics in Seattle, who was not involved in either study. “This is something the field has beenlooking to do for the past five years.” Expressed primarily in regulatory T-cells, Foxp3 is essential to both their development and normal function. Loss-of-function Foxp3 mutations in mice and humans result in fatal autoimmune diseases. A research team led by Alexander Rudensky of the University of Washington in Seattle, with Ye Zheng as first author, used ex vivo T-cells from mice with Foxp3 knocked out or tagged with GFP. Using a chromatin immunoprecipitation (ChIP) protocol, the team located nearly 1,300 Foxp3 binding sites on the mouse genome, from which it identified 702 Foxp3-bound genes. “Unlike other transcription factors, Foxp3 binds to only a few sites in the genome,” observed Rudensky. “But its binding results in very efficient changes in gene expression.” Another study, led by Richard Young of the Whitehead Institute in Cambridge, Mass. and Harald von Boehmer of the Dana-Farber Cancer Institute in Boston, also used ChIP to identify Foxp3 binding sites. Out of more than 1,500 binding sites, they identified 1,119 genes bound by Foxp3. Instead of ex vivo T-cells, however, the researchers used T-cell hybridomas transfected with Foxp3. This made it easier to observe the effects of T-cell receptor stimulation, explained study’s first author, Alexander Marson. “Foxp3 exerts a much stronger influence on its target genes in stimulated cells than in unstimulated cells,” he noted. Ethan Shevach of the National Institutes of Health in Bethesda, Md., who was not involved in either study, said he preferred the use of normal T-cells — as in the Zheng et al. study — to hybridomas. “There is no evidence that the cell [Marson et al] transfect with Foxp3 is a regulatory T-cell,” Shevach said. Some of the direct targets of Foxp3 identified in the two studies — such as members of the irf family — are transcription factors in their own right, indicating a second layer of regulation mediated by Foxp3. The target lists also include a number of genes for cell surface molecules, such as CD28, and signal transduction, such as Cdc42. “Some of these targets are red herrings,” cautioned Shevach. “Foxp3 may bind to them, but they may have nothing to do with regulatory cell function.” The results from the two studies differ significantly. For instance, Zheng et al. noted that ctla4 — an important T-cell inhibitor — was bound and strongly upregulated by Foxp3, but Marson et al. did not observe this. Conversely, while both studies found that Foxp3 bound to the receptor for IL2, a key player in immune response, only Marson et al. found IL2 itself to be a target. Further, while Zheng et al. determined that Foxp3 activated more genes than it suppressed, Marson et al. came to the opposite conclusion. “What I found most striking was the amount of non-overlap between the two datasets,” said Steve Ziegler of the Benaroya Research Institute in Seattle. “This may reflect the fact that they used two different systems for their chip-on-chip analysis.” Despite the discrepancies, experts said the studies would be a major help in research into immune tolerance. “Foxp3 is located in the nucleus and is hard to get at,” said Ziegler. “Downstream targets of it may be more accessible and give us more tractable surrogate markers of regulatory T-cells.” Chandra Shekhar cshekhar@the-scientist.com Links within this article Two papers: Y. Zheng, et al., “Genome-wide analysis of Foxp3 target genes in developing and mature regulatory T cells,” Nature, Jan 2007. A. Marson, et al., “Foxp3 occupancy and regulation of key target genes during T-cell stimulation,” Nature, Jan 2007. http://www.nature.com T.P. Toma, “Self-tolerance gene?” The Scientist, January 9, 2003 http://www.the-scientist.com/article/display/20994 M. Greener, “Hot on tolerance’s trail: The hunt for human Foxp3,” The Scientist, May 23, 2005http://www.the-scientist.com/article/display/15478 F. Ramsdell, “Foxp3 and natural regulatory T cells: Key to a cell lineage?” Immunity, August 2003. ‘http://www.immunity.com/content/article/abstract?uid=PIIS1074761303002073 Alexander Rudenskyhttp://depts.washington.edu/immunweb/faculty/profiles/rudensky.html Richard Younghttp://jura.wi.mit.edu/young_public/index.html Harald von Boehmer http://www.dana-farber.org/res/physician/detail.asp?personID=232&RD=True&group=%28Researcher%29 Ethan Shevachhttp://www3.niaid.nih.gov/labs/aboutlabs/li/cellularImmunologySection Steve Zieglerhttp://www.benaroyaresearch.org/investigators/ziegler_steven

32.  Lasker Winners Announced

This year’s prizes honor pioneering work on the unfolded protein response, deep-brain stimulation, and the discovery of cancer-related genes.

By Tracy Vence | September 8, 2014

Kazutoshi Mori (left), Peter Walter (right) ALBERT AND MARY LASKER FOUNDATION Kazutoshi Mori of Kyoto University in Japan and Peter Walter of the University of California, San Francisco, have won the 2014 Lasker Award for basic medical research. Mori and Walter are being honored by the Albert and Mary Lasker Foundation for their work related to the unfolded protein response—a cellular stress response that has been implicated in several protein-folding diseases.

In its announcement, the foundation said that “Mori and Walter’s work has led to a better understanding of inherited diseases such as cystic fibrosis, retinitis pigmentosa, and certain elevated cholesterol conditions in which unfolded proteins overwhelm the unfolded protein response.”

Three years ago, the Lasker Foundation honored Franz-Ulrich Hartl and Arthur Horwich for their protein-folding work with its 2011 basic research award.

Meanwhile, Alim Louis Benabid of Joseph Fourier University in Grenoble, France, and Mahlon DeLong of the Emory University School of Medicine in Atlanta, Georgia, have won the this year’s Lasker-DeBakey Clinical Medical Research Award for their deep-brain stimulation work that has been used to help restore and motor function in patients with advanced Parkinson’s disease.

And the University of Washington’s Mary-Claire King has won the 2014 Lasker-Koshland Special Achievement Award in Medical Science for “bold, imaginative, and diverse contributions to medical science and human rights” related to her work to reunite missing persons or their remains with their families, as well as her discovery of the cancer-related BRCA1 gene locus. In a commentary published in JAMA today (September 8), King and her colleagues advocated for population-based screening for cancer-related genetic variants. “Population-wide screening will require significant efforts to educate the public and to develop new counseling strategies, but this investment will both save women’s lives and provide a model for other public health programs in genomic medicine,” they wrote.

This year’s recipients will receive a $250,000 honorarium per category. The awards will be presented on Friday, September 19, in New York City.

33.  Protein Binding

Edited by: Thomas W. Durso S.D. Rosen, C.R. Bertozzi, “The selectins and their ligands,” Current Opinion in Cell Biology, 6:663-73, 1994. (Cited in more than 60 publications through April 1996) Comments by Steven D. Rosen, University of California, San Francisco The selectins are a trio of related proteins involved in leukocyte-endothelium interactions, affecting the ability of leukocytes-that is, white blood cells-to interact with blood vessel walls. THREEPEAT: The selectins are a threesome

By Carolyn Bertozzi | October 28, 1996

Edited by: Thomas W. Durso
S.D. Rosen, C.R. Bertozzi, “The selectins and their ligands,” Current Opinion in Cell Biology6:663-73, 1994. (Cited in more than 60 publications through April 1996) Comments by Steven D. Rosen, University of California, San Francisco

The selectins are a trio of related proteins involved in leukocyte-endothelium interactions, affecting the ability of leukocytes-that is, white blood cells-to interact with blood vessel walls.

THREEPEAT: The selectins are a threesome of related proteins, says UC-San Francisco’s Steven Rosen.

“One of the novel aspects of the selectins is that they function as carbohydrate-binding receptor molecules-that is, they recognize specific carbohydrate structures as their ligands, or counter-receptors,” Rosen says. “This means that in principle, it’s possible to interrupt the function of selectins by determining what carbohydrates they bind to and providing mimics for those carbohydrates in the form of soluble small molecules, thereby arriving at a new class or classes of anti-inflammatory substances.”The paper summarizes the three selectins and their physiological functions in leukocyte-endothelium interactions, and describes how they function.First identified at the molecular level in 1989 (L.M. Stoolman, Cell,56:907-10, 1989), selectins are the topic of this review paper by Steven D. Rosen, a professor in the department of anatomy and program in immunology at the University of California, San Francisco, and Carolyn R. Bertozzi, a former postdoc in Rosen’s lab and now an assistant professor of chemistry at the University of California, Berkeley.

Rosen explains that with leukocytes moving from the blood into tissues, the leukocyte-endothelium interaction is critical to inflammatory reactions.

ONE PLACE: UC-Berkeley’s Carolyn Bertozzi, Rosen’s former postdoc, was coauthor of the review paper.

“Leukocytes in tissue sites are protecting the individual from bacterial invasions and foreign substances that the individual wants to eliminate, but leukocytes can have an arsenal of destructive capabilities which can be turned on the individual’s own tissues. So inflammatory reactions have a down side. There are a lot of inflammatory diseases, such as rheumatoid arthritis, multiple sclerosis, lupus, and other autoimmune diseases.””In many cases, inflammatory reactions lead to pathological problems,” he points out. “It’s a defense mechanism the body has, but leukocytes being in tissue sites can cause problems as well as be of value to the individual.

He concludes: “The interest in the selectins was: Here’s a family of proteins that has involvement in leukocyte-endothelium interactions, therefore here’s a potential set of targets to prevent leukocyte entry into tissues and prevent inflammatory problems.”

Asked for his opinion on why this paper has been cited so much, Rosen replies: “There’s a huge amount of interest in the selectins, because there’s basic cell biology and biochemistry that everybody’s interested in here. . . . There’s a real convergence of the basic science with direct clinical applications. What you do in the lab can have immediate ramifications on the design of anti-inflammatory compounds. There’s tremendous biotech and pharmaceutical company interest in the selectins and their ligands.

“This has been a tremendously hot topic since 1989, and it will be for years to come. Our article put everything down in one place, from the basic cell biology to the clinical connections, and updated the carbohydrate information and ligand identification information in a very accessible way.”

In addition to reviewing the selectins, Rosen states, “the paper deals with what is known about the carbohydrates that the selectins recognize, and what is known about the macromolecules-the ligands-that carry these carbohydrates. What might make the carbohydrates that one selectin recognizes different from the carbohydrates that another selectin molecule might recognize-that is, what is the selectivity of carbohydrate binding among the three selectins?”

The paper also lists the animal models of inflammatory diseases in which selectins have been shown to play an important role, “where antagonism of the selectin leads to beneficial effects, in terms of decreasing damage,” Rosen notes.

Since the publication of this paper, he and Bertozzi have written a second review, updating ligand characterizations (S.D. Rosen, C.R. Bertozzi, Current Biology6:261-4, 1996).

“It has a lot more on carbohydrate specificity, and it’s got some new information on how one of the selectins recognizes its ligands,” Rosen notes. “Sulfation is important. At the time of the first review, sulfation was known to be important for the binding of one selectin to its ligands. . . . This review points to the importance of sulfation for the ligand of another selectin. The nature of the sulfation modifications of the ligands are very different for the two selectins.”

Additional LPBI articles:

MIT’s Promise for the MI Patient: A new cardiac patch uses Gold Nanowires to enhance Electrical Signaling between heart cells

Curator: Aviva Lev-Ari, PhD, RN

http://pharmaceuticalintelligence.com/2013/07/25/mits-promise-for-the-mi-patient-a-new-cardiac-patch-uses-gold-nanowires-to-enhance-electrical-signaling-between-heart-cells/

Nanotechnology and Heart Disease

Author and Curator:  Tilda Barliya PhD

http://pharmaceuticalintelligence.com/2013/03/04/nanotechnology-and-heart-disease/

AAAS February 14-18, 2013, Boston: Symposia – The Science of Uncertainty in Genomic Medicine

Reporter: Aviva Lev-Ari, PhD, RN

http://pharmaceuticalintelligence.com/2013/01/20/aaas-february-14-18-2013-bostonsymposia-the-science-of-uncertainty-in-genomic-medicine/

Robert S. Langer, Massachusetts Institute of Technology

Challenges and Opportunities at the Confluence of Biotechnology and Nanomaterials

Introduction to Tissue Engineering; Nanotechnology applications

Author, editor; Tilda Barliya PhD

http://pharmaceuticalintelligence.com/2013/01/01/introduction-to-tissue-engineering-nanotechnology-applications/

Building a Drug-Delivery System(DDS): choice of polymers and drugs

Author: Tilda Barliya PhD

http://pharmaceuticalintelligence.com/2012/10/04/building-a-drug-delivery-systemdds-choice-of-polymers-and-drugs/

Read Full Post »

Rosa’s to like

Curator & Reporter: Larry H. Bernstein, MD, FCAP

 

 

Reality Check: Cancer Experts Discuss Hurdles Facing CAR-T Therapy

http://www.xconomy.com/national/2015/09/18/reality-check-cancer-experts-discuss-hurdles-facing-car-t-therapy/

BEN FIDLER

September 18th, 2015

There’s a lot of excitement these days about a type of cellular immunotherapy known as CAR-T, a method of modifying peoples’ immune cells to fight cancer. But you could also fill a book listing all the problems its makers will have to solve—how to test, manufacture, and even the define the nature of these cancer-killing cells—before the CAR-T story is a successful one.

These hurdles, not the hype, were the subject of a panel of experts from industry, academia, and the FDA at the Inaugural International Cancer Immunotherapy Conference in New York Thursday afternoon. The panelists included University of Pennsylvania professor Carl June, whose work has led to programs now in clinical testing at Novartis; Adaptimmune executive vice president Gwendolyn Binder-Scholl; and GlaxoSmithKline’s head of immuno-oncology Cedrik Britten, among others.

CAR-T stands for chimeric antigen receptor T cell, which describes an engineered version of the immune system’s attack dogs. CAR-T cells are a patient’s own T cells altered outside the body to be cancer killers, then put back in to go after tumor cells.

CAR-T therapies from Novartis, Juno Therapeutics (NASDAQ: JUNO), and Kite Pharma (NASDAQ: KITE) have produced impressive results so far for certain blood cancers, leading to long-lasting remissions in some patients.

But the field is early in its development. Researchers are trying to figure out how to make these therapies useful for more common cancers, such as lung, breast, and ovarian, and how to mitigate the overactive immune responses they can cause. Biotechs and pharma companies developing autologous therapies—which modify the cells of each individual patient—are wrestling with how to manufacture and distribute them at scale.

But a different, larger question looms, and it gets to the heart of why autologous T cell therapy is truly a new medical frontier. The cells that are delivered back into the patient are not what ends up doing the bulk of the therapeutic work.

The panelists Thursday noted how T cell therapies could throw a wrench into a typical, and crucial, clinical strategy. Early in the clinical testing of a drug, companies usually run what are known as dose escalation studies. Different doses of products are tested, low to high, to establish a trend of responses, see what safety issues pop up, and pick the optimal dose to move forward.

But because CAR-T cell populations expand once they’re put back into a patient’s body, doses are harder to define. What’s more, cranking up a dose for such a powerful therapy could be dangerous. “Are classical trial designs applicable, or do they have to be changed?” asked GSK’s Britten. “You can not have a simple dose escalation [study] with a drug that replicates.”

Adaptimmune’s Binder-Scholl called for more guidance from regulators to help figure out a more standardized scheme for dose escalation studies.

“I think the biology is going to make [that type of guidance] awfully challenging,” says Juno’s chief financial officer Steve Harr, who also wasn’t on the panel. “I would like to think over time we get into something a bit more predictable, and maybe we have some type of a standard, but we’re very early in this process.”

 

Medscape Cardiology Black on Cardiology

SPRINT Hypertension Trial: Preliminary Results Discussed

http://www.medscape.com/viewarticle/851134?nlid=88408_2021&src=wnl_edit_medp_card&uac=211176CK&spon=2&impID=829281&faf=1

Henry R. Black, MD; William C. Cushman, MD    Disclosures | Sept 18, 2015

Stopped Early for Benefit

Henry R. Black, MD: Hi. I’m Dr Henry Black. I’m adjunct professor of medicine at the Langone New York University School of Medicine, and I’m here today with my long-term friend and colleague, Dr Bill Cushman. Bill, thank you very much for doing this.

William C. Cushman, MD: Delighted to be here.

Dr Black: What I want to talk about is the SPRINT study,[1]which you’ve been a primary participant in. The top-line resultswere just released. Tell us a little bit about SPRINT: who was in it, what the hypothesis was, and how it compares to the ACCORD study, which you also participated in.

Dr Cushman: Sure. I’m Dr Bill Cushman. I’m from Memphis, Tennessee. And I’m chief of the preventive medicine section at the VA and professor of preventive medicine at the University of Tennessee.

I was a network principal investigator in SPRINT, which meant that I oversaw about a quarter of the sites. SPRINT was a study sponsored by the National Institutes of Health (NIH), primarily the National Heart, Lung, and Blood Institute (NHLBI). But other institutes—the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute on Aging, the National Institute of Neurological Disorders and Stroke—were also involved.

SPRINT was a study of 9361 participants who were randomized to either a lower, more intensive goal of less than 120 mm Hg systolic blood pressure (SBP) compared with a goal of less than 140 mm Hg systolic. That was considered standard when we designed the study, and all guidelines recommended at least getting below 140 mm Hg.

We recruited a participant pool of high-risk hypertensive patients with SBPs of ≥130 mm Hg. They could be on medications (the majority were), but they didn’t have to be. Participants not only had to have elevated blood pressure, but they also had to be above age 50 and they had to have some other indices of risk: known cardiovascular disease, chronic kidney disease, or being above age 75, for example, or having a Framingham risk assessment for cardiovascular disease of ≥ 15% over 10 years.

They were randomly allocated to these two groups, with the intent of being followed for about 5 years. The primary outcome in SPRINT was a combined cardiovascular outcome that included myocardial infarction (MI), acute coronary syndrome other than MI, stroke, heart failure, or cardiovascular death.

Now, there are a lot of other outcomes in SPRINT, including whether this lower blood pressure goal would prevent dementia, changes on MRI, or chronic kidney disease. Those outcomes have not been stopped or announced yet, and we’re still collecting data on that.

The cardiovascular outcomes were viewed as so positive in terms of the benefit that the Data and Safety Monitoring Board recommended to Gary Gibbons, the director of the NHLBI, that the cardiovascular part of the trial—and the intensive intervention in particular—should be stopped and that the investigators and the participants should be unblinded. And that was done.

Dr Black: Were the antihypertensive regimens prescribed, or was it whatever the docs wanted to do?

Dr Cushman: Good point. We actually recommended using the major classes that were proven to be of benefit in cardiovascular outcome trials in hypertension: either thiazide-type diuretics, ACE inhibitors, angiotensin receptor blockers, or calcium blockers. It was primarily those four classes, and they could be combined in whatever way the investigators wanted. We did put a lot of emphasis on using thiazide-type diuretics because of the ALLHAT[2] results.

But the way they could be combined was really up to the investigators. Now, if the participants had known coronary disease or some other indication for a beta-blocker, that could certainly be used. And then other drugs could be added. We had a very large formulary representative of all the major classes of drugs— not only those classes, but also beta-blockers, alpha blockers, aldosterone inhibitors (spironolactone or amiloride, for example).

We had a lot of drugs available. They were predominantly purchased for the study, by NIH. There were only two drugs that were donated by the pharmaceutical companies. The study was entirely funded by NIH.

SPRINT vs ACCORD

Dr Black: How is this different from ACCORD?[3]

Dr Cushman: In ACCORD, we had the same two SBP goals: less than 120 mm Hg compared with a SBP of less than 140 mm Hg. However, SPRINT is twice as large as ACCORD.

As you may remember, we did not show a significant benefit for the lower SBP goal for the overall cardiovascular outcome in the ACCORD trial. We did see a significant reduction in stroke of about 40%, but that was a secondary outcome. The primary outcomes in mortality were not reduced in ACCORD.

However, ACCORD was about half the size of SPRINT. And even though the ACCORD blood pressure study was done in patients with diabetes, on average, they were probably a little lower-risk than our SPRINT participants because of their somewhat younger age (average age, 62 years), the absence of real chronic kidney disease, and several other reasons.

Even though ACCORD didn’t show a statistically significant benefit, it did show a 12% reduction in the cardiovascular outcome with a confidence interval that could have included up to a 27% benefit.

In contrast, SPRINT was twice as large, with a higher-risk population with an older average age. We excluded people with diabetes because that was being looked at in ACCORD. And we excluded people who’d had a prior stroke because that was being looked at in the SPS3[4] post-stroke study in terms of blood pressure goals.

Despite that, we had a very high-risk population. And what we found was about a third of a reduction in the primary cardiovascular events. That was significant.

We also saw, quite importantly, about a 25% reduction in all-cause mortality. That was surprising. The results are quite clear that there’s dramatic benefit in terms of both cardiovascular events and total mortality.

Dr Black: You probably can’t tell us this yet, but what was the blood pressure achieved in the less-than-140 group compared with the less-than-120 group?

We also saw, quite importantly, about a 25% reduction in all-cause mortality. That was surprising. The results are quite clear that there’s dramatic benefit in terms of both cardiovascular events and total mortality.

 

Diabetes Drug Empagliflozin Cuts CV Deaths in Landmark EMPA-REG Trial

http://www.medscape.com/viewarticle/851114?nlid=88408_2021&src=wnl_edit_medp_card&uac=211176CK&spon=2&impID=829281&faf=1

Lisa Nainggolan

STOCKHOLM ( updated with commentary ) — Patients with type 2 diabetes and established cardiovascular disease receiving the glucose-lowering agent empagliflozin (Jardiance, Boehringer Ingelheim/Lilly), a sodium glucose cotransporter-2 (SGLT-2) inhibitor, were less likely to die than those taking placebo in the large, much-anticipated EMPA-REG OUTCOME study, hailed here as a landmark trial.

The benefit on survival was seen regardless of the cause of death — empagliflozin prevented one in three cardiovascular deaths, with a significant 38% relative risk reduction in cardiovascular mortality, as well as a significant 32% relative reduction in all-cause mortality.

CV death was one component of the primary composite outcome, which also included nonfatal myocardial infarction (MI) or nonfatal stroke. It was the CV mortality benefit, however, that primarily drove the reduction in this end point.

“Empagliflozin is reducing death, the ultimate outcome,” senior author of the study, Silvio Inzucchi, MD, of Yale Diabetes Center, New Haven, Connecticut, told Medscape Medical News. “This is a first in my lifetime — a diabetes drug trial that has shown improved outcomes in high-risk cardiovascular patients.”

This is a first in my lifetime — a diabetes drug trial that has shown improved outcomes in high-risk cardiovascular patients.

Dr Inzucchi was given multiple rounds of applause as he presented the findings of EMPA-REG OUTCOME here at the European Association for the Study of Diabetes (EASD) 2015 Meeting, The study was also published simultaneously in the New England Journal of Medicine, by a team led by Bernard Zinman MD, director, Diabetes Centre, Mount Sinai Hospital, Toronto, Ontario.

 

Sept 17, 2015   http://dx.doi.org:/10.1056/NEJMoa1504720

Type 2 diabetes is a major risk factor for cardiovascular disease,1,2 and the presence of both type 2 diabetes and cardiovascular disease increases the risk of death.3 Evidence that glucose lowering reduces the rates of cardiovascular events and death has not been convincingly shown,4-6although a modest cardiovascular benefit may be observed after a prolonged follow-up period.7Furthermore, there is concern that intensive glucose lowering or the use of specific glucose-lowering drugs may be associated with adverse cardiovascular outcomes.8 Therefore, it is necessary to establish the cardiovascular safety benefits of glucose-lowering agents.9

 

Cohen’s Brain Bits: Let the Sunshine in?

http://www.medpagetoday.com/Blogs/CohensBrainBits/53630?xid=nl_mpt_DHE_2015-09-19&eun=g337145d0r    Published: Sep 18, 2015

By Joshua Cohen MD, MPH

Vitamin D is actually not a vitamin at all — it is a group of fat-soluble steroid hormones responsible for a host of important functions in the body. As it is found in low levels in most foods other than fish and dairy, vitamin D is primarily synthesized from cholesterol in the skin upon exposure to UVB radiation.

While the discovery of vitamin D nearly a century ago stemmed from its role in calcium homeostasis and metabolism, an abundance of studies in the past decade have demonstrated the critical role vitamin D plays in neuronal development and protection. Indeed, in the past few years, researchers have uncovered an association between vitamin D deficiency and an array of important neurologic diseases.

study in this week’s JAMA Neurology investigated the relationship between vitamin D levels, as measured in the blood as 25-hydroxyvitamin D, and the rate of cognitive decline in a population of 382 multi-ethnic older adults. Both vitamin D insufficient (12-20 ng/mL) and deficient (<12 ng/mL) participants demonstrated accelerated cognitive decline in multiple functional domains, especially episodic memory and executive function, that are the domains most affected in patients with Alzheimer’s dementia.

Previous studies have emphasized the essential role of vitamin D in the brain and have raised concern about the effect of vitamin D deficiency on the brain. Vitamin D’s neuroprotective roles include stimulation of neurotrophin release, neuroimmunomodulation, and interaction with reactive nitrogen and oxygen species. Vitamin D appears to also play a role in neurodevelopment through its regulation of nerve growth factor synthesis. Imaging studies have found increases in white matter hyperintensities and enlarged ventricles in vitamin D deficient study participants.

 

Channel Molecular Noise to Keep Cells Healthy

http://www.genengnews.com/gen-news-highlights/channel-molecular-noise-to-keep-cells-healthy/81251746/

Molecular fluctuations or noise within and among cells can be manipulated to control the networks that govern the workings of living cells—promoting cellular health and potentially alleviating diseases such as cancer. [Daniel K. Wells]

Complex networks are noisy, whether they constitute food webs, power grids, or cells. And when networks buzz and crackle beyond normal bounds, bad things can happen: ecosystems can collapse, power grids can leave us in the dark, and cells can tumble into cancerous states.

All these networks are amenable to similar mathematical treatments says a scientific team at Northwestern University. The team, led by physicist Adilson E. Motter, Ph.D., substantiated this claim by focusing on a particularly difficult biophysical problem: the rational control of cellular behavior. To date, attempts to exert such control have been frustrated by the high dimensionality and noise that are inherent properties of large intracellular networks.

Dr. Motter and his colleagues noted that the response of biological systems to noise has been studied extensively. Yet they also realized that little had been done to exploit noise, or to at least channel it. They hoped to find a way to do so and thereby demonstrate the possibility of preserving or inducing desirable cell states.

Using a newly developed computational algorithm, Dr. Motter and colleagues showed that molecular-level noise can be manipulated to control the networks that govern the workings of living cells—promoting cellular health and potentially alleviating diseases such as cancer. They presented their results September 16 in the journal Physical Review X, in an article entitled, “Control of Stochastic and Induced Switching in Biophysical Networks.”

“Here we present a scalable, quantitative method based on the Freidlin-Wentzell action to predict and control noise-induced switching between different states in genetic networks that, conveniently, can also control transitions between stable states in the absence of noise,” wrote the authors. “We apply this methodology to models of cell differentiation and show how predicted manipulations of tunable factors can induce lineage changes, and further utilize it to identify new candidate strategies for cancer therapy in a cell death pathway model.”

Essentially, by leveraging noise, the team found that the high-dimensional gene regulatory dynamics could be controlled instead by controlling a much smaller and simpler network, termed a “network of state transitions.” In this network, cells randomly transition from one phenotypic state to another—sometimes from states representing healthy cell phenotypes to unhealthy states where the conditions are potentially cancerous. The transition paths between these states can be predicted, as cells making the same transition will typically travel along similar paths in their gene expression.

The team began by using noise to define the most-likely transition pathway between different system states, and connecting these paths into the network of state transitions. By doing so, the researchers could then focus on just one path between any two states, distilling a multidimensional system to a series of one-dimensional interconnecting paths.

Then, using their computational approach, the team identified optimal modifications of experimentally adjustable parameters, such as protein activation rates, to encourage desired transitions between different states.

 

Mitochondrial Protein Finding May Allow Scientists to Control Apoptosis

http://www.genengnews.com/gen-news-highlights/mitochondrial-protein-finding-may-allow-scientists-to-control-apoptosis/81251742/

http://www.genengnews.com/Media/images/GENHighlight/Sep18_2015_NIH_Mitochondria1481397318.jpg

A protein embedded in the surface of mitochondria opens the door to apoptosis, causing cells to experience severe power failures, according to new work by researchers at Temple University School of Medicine. The study, appearing in Molecular Cell, suggests that blocking the door with a small-molecule inhibitor could be key to the treatment of cardiovascular diseases such as heart attack and stroke, where extensive mitochondrial dysfunction and cell death hinder tissue recovery.

The study (“SPG7 Is an Essential and Conserved Component of the Mitochondrial Permeability Transition Pore”), led by Muniswamy Madesh, Ph.D., associate professor in the department of biochemistry, the Cardiovascular Research Center, and the Center for Translational Medicine at Temple University School of Medicine (TUSM), shows that the protein, spastic paraplegia 7 (SPG7), is the central component of the so-called permeability transition pore (PTP), a protein complex in the mitochondrial membrane that mediates necrotic cell death (death caused by cell injury).

The identification of SPG7 marks a major advance in scientists’ understanding of how the PTP affects necrosis. Although first described in 1976, the molecular parts of the pore have eluded discovery. “The only known molecular component of the PTP prior to our discovery of SPG7 was a protein called CypD, which is necessary for pore function,” Dr. Madesh explained.

To identify genes that modulate PTP opening induced by calcium overload or increased levels of reactive oxygen species (ROS), the two primary factors that cause mitochondrial dysfunction and cell death via pore opening, Dr. Madesh’s team devised an RNA interference-based screen in which the activity of each gene under investigation was knocked down, or silenced, to examine its effects on mitochondrial calcium levels.

The researchers began with a panel of 128 different genes but after initial screening narrowed the field to just 14 candidate PTP components. Subsequent experiments showed that the loss of only one of them, SPG7, prevented pore opening.

Much of what is known about the PTP comes from studies of mitochondria in disease. In pathological states, particularly those involving hypoxia, calcium, and ROS accumulate within mitochondria, causing them to swell and prompting the PTP to open. Because pore opening disrupts the flow of electrons and protons across the mitochondrial membranes, which normally sustains energy production, it results in a catastrophic drop in cellular energy levels.

In the absence of disease, precisely how the PTP helps to mediate normal cellular physiology remains unclear. According to Dr. Madesh, “Under physiological conditions, SPG7 may function through transient pore openings to release toxic metabolites that have accumulated in mitochondria.” He plans to explore this possibility with knockout animal models.

 

“See-Through” Brain Developed by Japanese Researchers

http://www.genengnews.com/gen-news-highlights/see-through-brain-developed-by-japanese-researchers/81251727/

Scientists at the RIKEN Brain Science Institute in Japan have developed a new method for creating transparent tissue that can be used to illuminate 3D brain anatomy at high resolutions. Published in Nature Neuroscience, the work showcases the novel technology and its practical importance in clinical science by showing how it has given new insights into Alzheimer’s disease plaques.

“The usefulness of optical clearing techniques can be measured by their ability to gather accurate 3D structural information that cannot be readily achieved through traditional 2D methods,” explains lead scientist Atsushi Miyawaki, M.D., Ph.D. “Here, we achieved this goal using a new procedure, and collected data that may resolve several current issues regarding the pathology of Alzheimer’s disease. While Superman’s x-ray vision is only the stuff of comics, our method, called ScaleS, is a real and practical way to see through brain and body tissue.”

In recent years, generating see-through tissue—a process called optical clearing—has become a goal for many researchers in life sciences because of its potential to reveal complex structural details of our bodies, organs, and cells—both healthy and diseased—when combined with advanced microscopy imaging techniques. Previous methods were limited because the transparency process itself can damage the structures under study.

The original recipe reported by the Miyawaki team in 2011, termed Scale, was an aqueous solution based on urea that suffered from this same problem. The research team spent five years improving the effectiveness of the original recipe to overcome this critical challenge, and the result is ScaleS, a new technique with many practical applications.

“The key ingredient of our new formula is sorbitol, a common sugar alcohol,” notes Dr. Miyawaki. “By combining sorbitol in the right proportion with urea, we could create transparent brains with minimal tissue damage, that can handle both florescent and immunohistochemical labeling techniques, and is even effective in older animals.”

The team has devised several variations of the Scale technique that can be used together. By combining ScaleS with AbScale—a variation for immunolabeling—and ChemScale—a variation for fluorescent chemical compounds—they generated multicolor high-resolution 3D images of amyloid beta plaques in older mice from a genetic mouse model of Alzheimer’s disease developed at the RIKEN BSI by the Takaomi Saido team.

After showing how ScaleS treatment can preserve tissue, the researchers put the technique to practical use by visualizing in 3D the mysterious “diffuse” plaques seen in the postmortem brains of Alzheimer’s disease patients that are typically undetectable using 2D imaging. Contrary to current assumptions, the diffuse plaques proved not to be isolated, but showed extensive association with microglia —mobile cells that surround and protect neurons.

 

GEN Roundup on Cell-Based Assays for Biological Relevancy

Cell-Based Assay Platforms are Evolving to Meet Diverse Challenges

  • Cell-based assay platforms are evolving to meet diverse challenges—mimicking disease states, preserving signaling pathways, modeling drug responses, and recreating environments conducive to tissue development.

GEN recently interviewed a number of experts on cell-based assay technology to get a sense of the state of the art and to find out where this technology might be most valuable to life sciences research.

  • GEN: What are some of the main challenges that are faced when validating cell-based assays?
  • Dr. Kelly: Considerable challenges come from using systems involving a living organism in the validation of cell-based assays. The characteristics of such systems will likely affect the criteria for validation suitability. These criteria might be specific for primary cells, immortalized cell lines, cancerous cell lines, or cells generated de novo from multipotent stem cells.
  • Chemical reagents are generally well characterized by parameters such as molecular weight, solubility, etc., which are unlikely to change between assays.
  • However, characteristics of primary cells or established cell lines, such as viability, growth phase, proliferation rate, level of metabolism, and even cell size are much more vulnerable.
  • Mr. Trinquet: Beyond developing the right cell-based assay, the main challenge remains the relevancy of the cell model for the target being investigated. Generally, a single assay must also be compatible with a broad variety of cell technologies/models, from engineered cells to more complex models, such as 2D, 3D, microtissue, primary culture, and induced pluripotent stem cell models.
  • This certainly adds some difficulty, given that protein expression levels may differ from one model to another. Also, these assays must generally translate well all along the value chain, from high-throughput screening to late stages of lead op, so that end users do not have to switch between too many assay technologies.
  • Dr. Hsu: Cell-based assays provide more biologically relevant information than biochemical assays for high-throughput screening and ADME/Tox. One challenge in developing and validating cell-based assays is to generate cells that reliably express the drug target and give reproducible results with good Z′ over time.
  • We developed and launched the industry’s first cell-based assays and profiling services for G-protein-coupled receptors. The expression of G-protein-coupled receptors has been worked out, but ion channels are challenging. Another challenge is to make sure the assays and readouts are target specific and predictive, with a good dynamic range and signal-to-noise ratio to differentiate compounds with different potencies and efficacies.
  • Dr. Khimani: Cell-based assays provide a complex and physiologically relevant medium to evaluate the effect of novel therapeutic or modulatory candidates. However, unlike traditional assay formats, cell-based assays introduce a number of challenging factors that must be considered—such as cell type, expression level, stability, and passage viability—when optimizing the assay conditions.
  • In addition, with complex cell-based assay systems, data extraction and signal-to-noise optimization can be time-consuming bottlenecks. Other challenges, particularly with high-content screening, include separate investments in instrumentation, training, data analysis, and data management, all leading to a lower throughput.
  • Dr. Fan: Cell-based assays are model systems, and the most critical challenge facing such assays is how well they reflect real biology. Cell-based assays offer great advantages over biochemical assays because they are conducted in cellular contexts. That said, most of the current cell-based assays use a homogeneous population of cells grown from immortalized cell lines, many of which express target proteins or reporters in excessive, nonphysiological amounts via transient transfection or randomly integrated stable clones. These cell models are far from the actual cellular context in normal or diseased tissue such as a tumor.
  • In addition, phenotypical consequences of an analyte of interest to the cell could reflect a combination of effects that a single cell-based assay would not be able to fully address. These factors impact the validation or correlation of the results of a cell-based assay with a phenotypical consequence, an animal model study, or a clinically relevant finding.
  • Dr. Piper: The most formidable challenge in generating and validating cell-based assays is achieving predictability and translatability. Next-generation re-targeting systems (such as the Jump-In™ platform) have made over-expression of genes, even multigene cassettes, fast, reliable, and easy compared to traditional single-cell cloning.
  • While simple overexpression of a target may be sufficient to drive a primary screen and identify hits, it often lacks a sufficiently complex pathophysiological context to robustly convert hits to lead candidates that are meaningful in clinical trials. These systems have value at early stages, but they would benefit from improvements or secondary screens that can better translate to clinical results.
  • Dr. Payne: The choice of a cell system remains a challenge. Cell lines produce reproducible results, but do not accurately model living systems. Although primary cells are more physiologically relevant, they are inherently variable, making it harder to deliver a robust cell-based assay.
  • Choosing appropriate endpoints can be time consuming: measuring one parameter is not enough to accurately determine the functionality of a drug. The ability to analyze several markers in multiplex assays provides greater information on drug efficacy and toxicity, the latter being important for failing flawed drugs earlier. Finally, once validated offline, assays still require revalidation when transferred to automated context.
  • GEN: What is more valuable to researchers with respect to cell-based assays miniaturization or ultra-high throughput?
  • Dr. Kelly: A single cell contains the complete genome of the species and thousands of expressed genes, implying that one cell could provide the same information as millions. High-throughput efforts should be aimed at our ability to multiplex, multivisualize, and microarray the enormous amount of information that one cell can provide.Mr. Trinquet: Miniaturization may be more important because the cells that are used are more complex and costly to produce massively. It comes to be particularly important when several assays need to be run in parallel using the same sample, such as cell lysate after stimulation.

 

Dana-Farber Researchers Use Gene Editing to Short-Circuit Sickle Cell Disease

Sep 16, 2015

a GenomeWeb staff reporter

NEW YORK (GenomeWeb) – Scientists have developed a gene editing strategy that could help treat sickle cell disease by short-circuiting the mutated hemoglobin causing the disease.

“We’ve now targeted the modifier of the modifier of a disease-causing gene,” Stuart Orkin, chairman of pediatric oncology at Dana-Farber Cancer Institute and associate chief of hematology/oncology at Boston Children’s Hospital, said in a statement. “It’s a very different approach to treating disease.”

Using CRISPR/Cas9 gene editing tools to systematically excise stretches of a promoter region of the enhancer gene BCL11A — which selects the type of hemoglobin that blood cells create — the researchers found an edit that inactivated BCL11A in human blood stem cells. The cut leads cells to increase levels of fetal hemoglobin, resulting in a milder form of sickle cell disease.

The scientists, led by Orkin and Daniel Bauer of Dana-Farber and Boston Children’s, and Feng Zhang of the Broad Institute, published their study today in Nature.

The human genome codes for both a fetal version and an adult version of hemoglobin. A mutation in the adult version of the protein causes sickle cell disease. BCL11A became a target of sickle cell disease research after Orkin’s laboratory revealed its direct role in the transition from fetal to adult hemoglobin in a 2009 study published in Nature. In 2013, a study led by Orkin and Bauer found the promoter region which controls expression of BCL11A in red blood cells.

 

Musical Scales

http://www.the-scientist.com//?articles.view/articleNo/43794/title/Musical-Scales/

The quest to document an ancient sea creature reveals a cyclical chorus of fish songs.

By Kerry Grens | September 1, 2015

http://www.the-scientist.com/Sept2015/notebook2.jpg

 

fish songs

fish songs

Several years ago, ichthyologist Eric Parmentier met a French marine biologist and filmmaker, Laurent Ballesta, who was organizing an expedition to South Africa to produce a documentary film on the coelacanth. This ancient fish—one whose fossil record dates back at least 350 million years—has an almost mythical legacy. Although it was widely assumed to have gone extinct 65 million years ago, a live specimen was found in 1938, and scientists have identified two extant species of coelacanth. Both species move in a peculiar way, waggling four lobe-like fins in an alternating pattern, as we do our arms and legs. Their anatomy is also unusual: a tiny brain, a joint at the back of the head that allows the animal to open its jaws widely, and only rudimentary vertebrae. Ballesta’s trip inspired Parmentier, who studies fish acoustics, to collaborate with the team. “I hoped to be the first guy to record [sounds of] the coelacanth.”

In the spring of 2013, divers successfully planted a hydrophone inside the cave and also shot video footage of a coelacanth. (The resulting documentary by Ballesta is available on YouTube. Although it is in French, the footage obviates the need for fluency to enjoy the film.) Day and night, for weeks, the hydrophone dutifully recorded the sounds within the cave. When Parmentier retrieved the files and went to analyze the recordings, there was one big problem: it was filled with dozens of different fish calls. “Maybe the coelacanth is in these sound files, but it’s completely masked by the other sounds,” he says.

Nonetheless, the tape captured ceaseless, never-before-heard chatter among the aquatic organisms within the cave (PNAS, 112:6092-97, 2015). To make some sense of it, Parmentier’s team undertook the laborious task of characterizing the sounds recorded over 19 nonconsecutive days (to make this feasible, the group pared down its analysis to the first nine minutes of every hour). The researchers assigned more than 2,700 sounds to 17 groups, most of which sounded to Parmentier like fish (one group was clearly dolphin, based on its high frequency, he says). These included frog-like croaks, grunts that sounded like a creaking door, a moan, and one that sounded like a whistle blown under water. “It’s fair to say, based on the characteristics of the sounds they were hearing, they are probably fish sounds,” says Erica Staaterman, a postdoc at the Smithsonian who studies fish acoustic communication.

 

NIH Awards Beth Israel Team $3M to Continue Study of Heart Disease Biomarker  Sep 17, 2015

a GenomeWeb staff reporter

NEW YORK (GenomeWeb) – The National Institutes of Health has awarded a Beth Israel Deaconess Medical Center (BIDMC) research team $3 million in funding to support the second phase of an effort to identify microRNAs that can be used to predict clinical outcomes of heart disease patients.

The grant, which was awarded under the NIH’s Extracellular RNA Communication program, follows a $4 million award the group received to kick off the project in 2013.

To date, the team has identified a number of miRNA biomarker candidates including miR-30d, which the researchers reported earlier this year as a predictor of beneficial cardiac remodeling in patients following a heart attack and a key player in preventing cell death.

With the latest grant, the investigators aim to validate miR-30d and other candidate miRNAs in several large patient cohorts.

microRNA-based tests

microRNA-based tests

https://www.youtube.com/watch?v=oMaiIyGfhQw

 

Unraveling determinants of transcription factor binding outside the core binding site

Michal Levo, Einat Zalckvar, Eilon Sharon, Ana Carolina Dantas Machado, Yael Kalma, Maya Lotam-Pompan, Adina Weinberger, Zohar Yakhini, Remo Rohs and Eran Segal. “Unraveling determinants of transcription factor binding outside the core binding site”. Genome Res. July 2015 25: 1018-1029.

http://genome.cshlp.org/content/25/7/1018.abstract

Binding of transcription factors (TFs) to regulatory sequences is a pivotal step in the control of gene expression. Despite many advances in the characterization of sequence motifs recognized by TFs, our ability to quantitatively predict TF binding to different regulatory sequences is still limited. Here, we present a novel experimental assay termed BunDLE-seq that provides quantitative measurements of TF binding to thousands of fully designed sequences of 200 bp in length within a single experiment. Applying this binding assay to two yeast TFs, we demonstrate that sequences outside the core TF binding site profoundly affect TF binding. We show that TF-specific models based on the sequence or DNA shape of the regions flanking the core binding site are highly predictive of the measured differential TF binding. We further characterize the dependence of TF binding, accounting for measurements of single and co-occurring binding events, on the number and location of binding sites and on the TF concentration. Finally, by coupling our in vitro TF binding measurements, and another application of our method probing nucleosome formation, to in vivo expression measurements carried out with the same template sequences serving as promoters, we offer insights into mechanisms that may determine the different expression outcomes observed. Our assay thus paves the way to a more comprehensive understanding of TF binding to regulatory sequences and allows the characterization of TF binding determinants within and outside of core binding sites.

 

Defective Mitochondria Transform Normal Cells into Tumors

http://www.genengnews.com/gen-news-highlights/defective-mitochondria-transform-normal-cells-into-tumors/81251487/

An international research team reports that defects in mitochondria, play a key role in the transition from normal cells to cancerous ones. When the scientists disrupted a key component of mitochondria, otherwise normal cells took on characteristics of cancerous tumor cells.

Their study (“Disruption of cytochrome c oxidase function induces the Warburg effect and metabolic reprogramming”) is published Oncogene and was led by members of the lab of Narayan G. Avadhani, Ph.D., the Harriet Ellison Woodward Professor of Biochemistry in the department of biomedical sciences in the school of veterinary medicine at the University of Pennsylvania. Satish Srinivasan, Ph.D., a research investigator in Dr. Avadhani’s lab, was the lead author.

In 1924, German biologist Otto Heinrich Warburg observed that cancerous cells consumed glucose at a higher rate than normal cells and had defects in their grana, the organelles that are now known as mitochondria. He postulated that the mitochondrial defects led to problems in the process by which the cell produces energy, called oxidative phosphorylation, and that these defects contributed to the cells becoming cancerous.

“The first part of the Warburg hypothesis has held up solidly in that most proliferating tumors show high dependence on glucose as an energy source and they release large amounts of lactic acid,” said Dr. Avadhani. “But the second part, about the defective mitochondrial function causing cells to be tumorigenic, has been highly contentious.”

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Cancer and Nutrition

Writer and Curator: Larry H. Bernstein, MD, FCAP

The following discussions have been a topic of great interest and much controversy. In this discussion I shall not cover the topics related to Alternative and Complementary Medicine that is discussed elsewhere.  However, there is significant reason to explore the relationships of vitamin and micronutrient insufficiencies to cancer. The following nutritional subjects will be the focus of these discussions.

  1. Transthyretin (TTR)
  2. Vitamin A (retinoids and retinol) and retinol-binding protein (RBP)
  3. Vitamin C
  4. Vitamin D
  5. Magnesium (Mg++)

Cancer, homocysteine, Alzheimer’s Disease, and cardiovascular disease

1 Transthyretin

1.1 Plasma Transthyretin Indicates the Direction of both Nitrogen Balance and Retinoid Status in Health and Disease

Ingenbleek Yves1 and Bienvenu Jacques2,3,*

1Laboratory of Nutrition, Faculty of Pharmacy, University Louis Pasteur Strasbourg 1, France; 2Laboratory of Immunology, Hospices Civils de Lyon and 3INSERM U 851, University Claude Bernard Lyon 1, France

The Open Clinical Chemistry Journal, 2008;  1:1-12
Abstract: Whatever the nutritional status and the disease condition, the actual transthyretin (TTR) plasma level is determined by opposing influences between anabolic and catabolic alterations. Rising TTR values indicate that synthetic processes prevail over tissue breakdown with a nitrogen balance (NB) turning positive as a result of efficient nutritional support and / or anti-inflammatory therapy. Declining TTR values point to the failure of sustaining NB as an effect of maladjusted dietetic management and / or further worsening of the morbid condition. Serial measurement of TTR thus appears as a dynamic index defining the direction of NB in acute and chronic disorders, serving as a guide to alert the physician on the validity of his therapeutic strategy. The level of TTR production by the liver also works as a limiting factor for the cellular bioavailability of retinol and retinoid derivatives which play major roles in the brain ageing process. Optimal protein nutritional status, as assessed by TTR values within the normal range, prevents the occurrence of vascular and cerebral damages while maintaining the retinoid-mediated memory, cognitive and behavioral activities of elderly persons.

INTRODUCTION  Measurement of transthyretin (TTR, formerly called prealbumin) was proposed as nutritional marker in The Lancet in 1972 [1]. This proposal was largely disregarded by the scientific community during the decade following its publication. TTR testing is now the most utilized nutritional marker worldwide, having received the strong support of the Prealbumin Consensus Group [2].  A minority of workers, however, remain doubtful [3] or even reluctant [4] to adopt TTR as nutritional index, stressing the point that its synthesis is also influenced by inflammatory conditions [3,4] and by other extra-nutritional factors such as natural or synthetic corticosteroids [5] and androgens [6]. The aim of the present review paper is to clarify the complex relationships linking malnutrition and inflammation, throwing further insight into a nutrition domain of increasing public health.

EVOLUTION, STRUCTURE AND FUNCTIONS  TTR is a highly conserved protein in vertebrate species already secreted by the choroid plexus of reptiles 300 millions years ago and remaining confined within the cerebrospinal fluid (CSF) [10]. Synthesis and secretion of TTR by the liver evolved much later, about 100 millions years ago, in birds and eutherian mammals [11]. Production of TTR by the liver and by the choroid plexus is regulated separately [12]. The human TTR gene has been localized on the long arm of the chromosome 18q23 [13]. The nucleotide sequences of the entire TTR gene, including the 5′ (transcription initiating site) and the 3′ (untranslated site) flanking regions have been described [14,15]. The gene spans 6.9 kilobases (kb) and consists of 4 exons and 3 introns [14,15]. The hepatic TTR mRNA measures 0.7 kb encoding a pro-TTR-monomer undergoing a cleaving process to release the native TTR monomer [16]. Four identical subunits each 127 amino acids (AAs) length coalesce noncovalently to generate the fully mature nonglycosylated molecule whose molecular mass (MM) reaches 55 kDa [17]. Two binding sites for thyroid hormones are buried inside the central channel of the TTR heterodimer [18]. The secondary, tertiary and quarternary conformation structures of the TTR protein have been reported using 1.8 Å Fourier analysis [18]. One TTR  monomer binds to a small companion protein (21 kDa MM) to which a single retinol is bound (all-trans-retinol), hence its RBP denomination [19]. X-ray crystallographic studies have shown that RBP possesses an eight-stranded -barrel core that completely encapsulates the retinol molecule [20]. Under usual circumstances, RBP is almost entirely saturated with retinol, explaining that the 3 components of the retinol circulating complex (RCC) of 76 kDa MM has a close 1:1:1 stoichiometry [21]. Aggregation of TTR to holo-RBP occurs within the endoplasmic reticulum prior to extracellular RCC secretion [22].  The TTR protein was first discovered in human CSF in 1942 [23] and soon after in human serum. Human TTR transports about 20% of the intravascular pool of both thyroid hormones (Thyroxine [T4], triiodothyronine [T3]) and at least 90-95% of the retinol circulating pool. The term transthyretin was recommended by the International Nomenclature Committee [26] stressing the dual conveying role played by TTR in all eutherians.

The biological half-life of TTR is approximately 2 days [27] whereas that of holo-RBP (RBP + bound retinol) is half a day [28]. By contrast, apo-RBP devoid of its retinol ligand displays a significantly reduced half-life of 3.5 hr [28] and undergoes rapid glomerular leakage with subsequent tubular disintegration and recycling of its AA residues. It is therefore assumed that TTR plays an important role in the safeguard of the retinol pool. The catabolic site of TTR is mainly the liver, followed by muscle mass, skin and kidneys [29].  The TTR molecule displays microheterogeneity [30] and tissue deposits occur throughout the normal ageing processes [31]. In contrast, TTR is characterized by a very large genetic polymorphism affecting about 100 different point mutations [32], leading to misfolded forms of the protein and occurrence of amyloid disorders in several organs. The tetrameric TTR protein is recognized as a component of the normal pancreatic cell structure, preserving its integrity against the risk of apoptosis [40]. Finally, normal TTR production is required for the maturation of brain neural stem cells [41] and for the control of spatial reference memory performances [42].

SIGNIFICANCE OF TTR THROUGHOUT THE HUMAN LIFESPAN  Significant alterations in the levels of protein intakes by humans affect protein synthesis, turnover and breakdown and determine the outcome of total body N (TBN).  Anabolism occurs when the rate of AA incorporation into protein exceeds that of oxidative losses, yielding a positive NB. Catabolism is the result of protein breakdown prevailing over protein synthesis [43]. Increasing gestational age is accompanied by a slow and predictable rise in TTR values correlated with birth weight and proved useful in distinguishing between small, appropriate and large for gestational age infants [47,48]. Starting from birth until 100 years of age, our reference TTR values [54] are those collected in the monograph ” Serum Proteins in Clinical Medicine ” edited by the Foundation for Blood Research. The plasma TTR concentrations in healthy neonates are approximately two thirds those measured in healthy mothers and thereafter increase slowly until the onset of puberty without displaying sexual differences. The rate of protein synthesis similarly increases linearly during the prepubertal period [55], consistent with superimposable N accretion rates [56]. Human puberty is characterized by major hormonal and metabolic alterations leading to increased height velocity and weight gain [60]. The onset of puberty requires close interrelationships between the effects triggered by growth hormone and  insulin-like growth factors, by thyroid and steroid hormones, by insulin and sex hormones [60]. Whereas androgens strongly promote the development of muscle mass in males and lipolytic effects on visceral and subcutaneous fat, estrogens have minimal effect on the female musculature while stimulating the accrual of subcutaneous fat depots [60]. Body composition studies indicate prepubertal redistribution of FM and FFM with a significantly higher S-shaped elevation of FFM in male adolescents compared with the blunted curve recorded in teenaged girls [61,62]. TTR values manifest closely paralleled sex- and age-peculiarities in process of time that are best explained by the deeper androgenic impregnation of male subjects [6,43]. The musculature is by weight the main component of FFM, representing 37% of body mass [61].  In healthy adults, the sex-related difference in plasma TTR-RBP concentrations is maintained at plateau levels after sexual maturity [54,63]. Normal TTR plasma values are stabilized around 290-320 mg/L in males and around 250-280 mg/L in females [54,63]. Starting from the sixties, TTR concentrations progressively decline over time, disclosing a steeper slope in elderly men that reflects a relatively more rapid deterioration of their muscle mass [43]. As a result, the earlier TTR sexual difference disappears by about the age of 70 years [43]. This correlates with the age-dependent curvilinear drop of TBN, characterized by an accelerated decrease after 65 years [64]. Taken together, the plasma TTR evolutionary patterns reveal a parallelism with FFM so that TTR serves as an indicator of muscle mass. The data show that age and gender are significant co-variates of TTR which require separate blood reference values [54].

TTR AS INDEX OF PROTEIN DEPLETION / REPLETION STATES  There exists a long-lasting debate aimed at identifying the most effective protein sources, level of energy-yielding substrates and the proportion among these for the support of protein metabolism. Under usual conditions, glucose functions as the major energy substrate for protein synthesis. If the carbohydrate energy is lacking, glucose must be synthesized by gluconeogenesis, mainly from the conversion of endogenous or dietary protein [65]. This corresponds to a form of nutritional wastage which augments the cost of protein synthesis, as documented by an increased urinary excretion of urea. The above metabolic pattern stands in broad conformity with the concept that ” protein synthesis occurs in the flame of sugars ” [66].

FAO/WHO/UNU recommends for healthy adults the safe level of 0.75 g k-1 day-1 protein intake [67]. Although this amount of protein sustains normal growth and keeps unmodified the concentration of most biological parameters, such intake appears to be marginally inadequate to maintain the metabolic reserve capacities that are required to mount optimal responses to stress [68]. Studies have disclosed that TTR plasma level and pool size remain unaltered because its synthetic and catabolic rates are both downregulated concomitantly [69]. Changes occurring during prolonged starvation causes the N balance to turn negative despite efforts to minimize protein catabolism [70]. There is a direct correlation between the rate of liver protein synthesis and intrahepatic concentrations of individual free AAs [71]. It is likely that the dietary limitation of some AAs such as tryptophan [72] or leucine [73] could specifically exert inhibitory effects on the transcriptional [74] or translational [75] regulation of protein synthesis. Consequently, protein depletion causes a decrease in TTR mRNA [72,74,76].

Transcription of the TTR gene in the liver is directed by CCAAT/enhancer binding protein (C/EBP) bound to nuclear factor 1 (NF1) [74]. Multiple hepatocyte nuclear factors (HNFs) function in the regulation of TTR gene expression [77]. It has been recently shown that one of them (HNF-4) plays prominent roles before and after injury [78]. The drop of liver TTR mRNA levels to about half as an effect of protein deprivation [74] is accompanied by a corresponding diminished secretion of mature TTR molecules in the bloodstream.

The rapidly turning over TTR protein is exquisitely sensitive to any change in protein and/or energy supply, being clearly situated on the cutting edge of the equipoise. This is documented in preterm infants in whom AA supply is responsible for maintaining normal protein synthesis which may be somewhat modulated by fluctuations in energy intake [79]. In the declared stage of protein malnutrition, the serial measurement of TTR may serve to grade the severity of the disease spectrum, from mild [90] to severe [1] forms. Both metabolic and structural N compartments undergo exhausting processes as documented by the fall of nitrogenous compounds in the urine of protein-depleted subjects [91]. The relative dominance of urea over ammonia catabolites [92] reflects the more intense turnover rate of tissues belonging to the readily mobilizable N pool. Decreased TTR plasma values are indeed correlated with the involution of the gut mucosa [93] and with the extent of liver dysfunction, more pronounced in the kwashiorkor disease with massive hepatic steatosis than in marasmus with limited fatty liver infiltration [1]. The structural N compartment nevertheless participates in the loss of body protein reserves, consistent with the reduced urinary output of creatinine [91], 3-methylhistidine [94] and soluble hydroxyproline [95]. The resulting sarcopenia [96,97] and the concomitant depression of immune mechanisms [98,99] render an account of the higher morbidity / mortality rates affecting TBN-depleted patients identified by the lowest TTR and RBP plasma concentrations [100]. The mortality risk of malnourished children in Central Africa becomes likely when SA and TTR reach the threshold of 16 g /L and 65 mg /L, respectively [101].

During nutritional rehabilitation from protein malnutrition, the restoration of visceral proteins occurs at different rates depending on the type of protein and the size of its plasma pool. TTR and RBP recovery appears as the main result of increased production rates by the liver [102]. Most studies contend the view that the trajectory outlined for TTR correlates with the fluctuations of body N mass, especially during the anabolic phase of growth and clinical recovery from protein malnutrition. Using impedance parameters for assessing the N compartment still remaining in place in the stressed body of adults undergoing renal dialysis, nephrologists were able to demonstrate close relationships between TTR and phase angle, reactance and resistance values [105]. In elderly noninfected persons, FFM index measured by dual X-ray absorptiometry exhibits the highest correlation with TTR (r = 0.64) compared to RBP (r = 0.52) [106]

TTR AS NITROGEN INDEX IN INFLAMMATORY DISORDERS  Inflammatory disorders of any cause are initiated by activated leukocytes releasing a shower of cytokines working as autocrine, paracrine and endocrine molecules [107]. Cytokines regulate the overproduction of acute-phase proteins (APPs), notably that of CRP, 1-acid glycoprotein (AGP), fibrinogen, haptoglobin, 1-antitrypsin and antichymotrypsin [107]. APPs contribute in several ways to defense and repair mechanisms, being characterized by proper kinetic and functional properties [107]. Interleukin-6 (IL-6) is regarded as a key mediator governing both the acute and chronic inflammatory processes, as documented by data recorded on burn [108], sepsis [109] and AIDS [110] patients. IL-6-NF possesses a high degree of homology with C/EBP-NF1 and competes for the same DNA response element of the IL-6 gene [111]. IL-6-NF is not expressed under normal circumstances, explaining why APP concentrations are kept at baseline levels. In stressful conditions, IL-6-NF causes a dramatic surge in APP values [107,112] with a concomitant suppressed synthesis of TTR as demonstrated in animal [113] and clinical [114] experiments.  Under acute stressful conditions, protein turnover is strongly stimulated by augmented tissue breakdown (mainly in the muscle mass) and enhanced specific tissues synthesis (mainly in the liver and at the site of injury). Proteolysis releases AA residues which are preferentially incorporated into the hepatic precursor pool involved in the production of APPs [115,116]. The rate at which proteins are degraded generally exceeds the rate of AA mobilization for protein synthesis [117,118] yielding a net negative NB associated with an increased urinary output of urea and ammonia [119]. Creatininuria and 3-methylhistidinuria are significantly elevated and remain highly correlated (r = 0.97) attesting to the substantial participation of the skeletal musculature to the stress responses [117]. The gap between degradative and synthetic processes widens in proportion to the severity of injury, resulting in correspondingly increased urinary N catabolites [43]. Serious injury affecting otherwise healthy adults may trigger urinary N losses reaching 40 g/day or 250 g/week, which corresponds to about 15% of TBN [43]. In long-lasting debilitating disorders, the persisting negative NB may deplete the baseline body cell mass by about 45%, carrying ominous prognostic significance [120].

Inadequate nutritional management [122], multiple injuries, occurrence of severe sepsis and metabolic complications result in persistent proteolysis [124] and subnormal TTR concentrations [66]. The evolutionary patterns of urinary N output and of TTR thus appear as mirror images of each other, which supports the view that TTR might well reflect the depletion of TBN in both acute and chronic disease processes. Even in the most complex stressful conditions, the synthesis of visceral proteins is submitted to opposing anabolic or catabolic influences yielding ultimately TTR as an end-product reflecting the prevailing tendency. Whatever the nutritional and/or inflammatory causal factors, the actual TTR plasma level and its course in process of time indicates the exhaustion or restoration of the body N resources, hence its likely (in)ability to assume defense and repair mechanisms. The serial measurement of TTR appears as a dynamic tool pointing to the direction and magnitude of NB, predicting therefore the disease outcome. Hundreds of studies are reporting the clinical usefulness of TTR measurement.  TTR is recommended for the assessment and nutritional follow-up of a large panel of hospitalized patients in internal medicine settings [130,131], in general surgery [132,133] and intensive care units [134,135]. Low TTR values thus appear to nonspecifically reflect the extent of liver damage rather than its etiology. Liver N tissue only represents by weight a minor proportion of TBN but its intense turnover rate (10 to 20-fold more rapid than that of muscle tissue) [43] and its critical involvement in the orchestration of most major metabolic and immune pathways [145] explains why liver failure of any cause is usually associated with varying degrees of clinical malnutrition [142].

The nutritional management of kidney patients has met noticeable improvement along the past decades. Until the mid 1980s TTR was regarded as unreliable and discarded, leaving the way for the general use of SA in kidney studies. The turning point came in 1987 when a careful statistical analysis stated that TTR was the most representative marker within a large battery of currently measured parameters [149]. The most recent studies clearly incline towards the common use of TTR superseding that of SA [8, 151-155]. It has been confirmed, mainly in intensive care renal units, that the serial measurement of TTR works as a strong independent predictor of long-term survival, allowing identification of the patients in need of nutritional intervention [151,155] or at risk of reduced life expectancy [154, 155]. Using proportional hazards regression models, the relative risk of death was inversely related to TTR concentrations in 8,157 hemodialyzed patients [155]. TTR is currently measured as nutritional marker in tropical areas where bacterial, viral and parasitic diseases are still highly prevalent, usually in connection with defective immune and vitamin A status, including malaria[156], trypanosomiasis [157], schistosomiasis [158], measles[159], shigellosis [160], and AIDS patients exhibit declining TTR values as the morbid condition worsens [161].

In westernized societies, elderly persons constitute a growing population group. A substantial proportion of them may develop a syndrome of frailty characterized by weight loss, clumsy gait, impaired memory and sensorial aptitudes, poor physical, mental and social activities, depressive trends. Hallmarks of frailty combine progressive depletion of both structural and metabolic N compartments [162]. Sarcopenia and limitation of muscle strength are naturally involutive events of normal ageing which may nevertheless be accelerated by cytokine-induced underlying inflammatory disorders [163,164]. Depletion of visceral resources is substantiated by the shrinking of FFM and its partial replacement by FM, mainly in abdominal organs, and by the down-regulation of indices of growth and protein status [162]. Due to reduced tissue reserves and diminished efficiency of immune and repair mechanisms, any stressful condition affecting old age may trigger more severe clinical impact whereas healing processes require longer duration with erratical setbacks. As a result, protein malnutrition is a common finding in most elderly patients [165] with significantly increased morbidity and mortality rates [166,167].

Measurement of visceral protein status is proved useful throughout the entire ageing lifespan. A wide range of co-morbidities associated with defective protein nutritional status is described in aging persons who become more prone to develop pressure sores [163], osteoporosis [170], oral candidiasis [171] and nuclear cataract [172].  The isolation and purification of rat TTR [173] has allowed to set up animal models. In normal rats, TTR manifests highly significant correlations with nutrient intakes and with visceral and carcass N stores [174]. In tumor-bearing rats, the progressive exhaustion of body protein mass towards cachexia states is correlated with declining TTR values [175]. TTR is currently utilized as indicator of protein nutritional status in cancer patients [176,177]. TTR is held as the most powerful test overall for evaluating visceral protein status of children with solid tumors [178] and leukemias [179] both at the time of diagnosis and throughout chemotherapy. In bone marrow transplantation for malignancies, TTR accurately reflects at any point changes in the patient’s clinical status [180]. TTR has proved to be a useful marker of nutritional alterations with prognostic implications in large bowel cancer [181], bronchopulmonary carcinoid tumor [182], ovarian carcinoma [183] and bladder epithelioma [184]. Many oncologists have observed a rapid TTR fall 2 or 3 months prior to the patient’s death [181]. In cancer patients submitted to surgical intervention, most postoperative complications occurred in subjects with preoperative TTR  180 mg/L [185]. Two independent studies came to the same conclusion that a TTR threshold of 100 mg/L is indicative of extremely weak survival likelihood and that these terminally ill patients better deserve palliative care rather than aggressive therapeutic strategies [185,186].

The AGP/TTR couple is recommended in chronic inflammatory disorders, notably in several cancer types [192,193]. Working along the same lines is the prognostic inflammatory and nutritional index (PINI) [194] which is successfully applied on large cohorts of patients. TTR also participates in the development of screening formulas recently generated by innovative analytical tools such as surface-enhanced laser desorption/ionization (SELDI) or matrix-assisted laser desorption/ionization (MALDI) coupled with time of flight mass spectrometry (TOF-MS). The advent of these sophisticated and costly proteomic fingerprinting studies of serum or other biological fluids are nevertheless promising in that they tentatively strive to identify the early stages of several disease conditions such as hepatitis B [195], tuberculosis [196], Alzheimer’s disease [197] or neoplastic disorders [198]. These proteomic detecting systems usually combine classical APP reactants with some minor biological compounds scarcely measured in routine laboratory practice such as cathepsin D, hemopexin, neopterin or vitronectin. The fact that most, if not all, of these fingerprinting formulas embody TTR measurement indicates that there exists among workers a large consensus considering this carrier-protein as the most reliable indicator of protein depletion in morbid circumstances.

PROGRESS IN TTR RESEARCH : THE BRAIN AGEING PROCESS  Dementia, defined as significant memory impairment and loss of intellectual functions, is a common and devastating public health problem, affecting an estimated 2-4% individuals over the age of 65 years. Two distinct clinicopathological conditions are usually taken into consideration as causative factors: Alzheimer’s disease (AD), a chronic and continuously progressing illness for which the only widely accepted risk conditions are age and family history of the disease; and cerebral infarction, a brain deteriorating process evolving along episodic and repetitive bouts so as to generate a syndrome of multi-infarct dementia (MID) [199]. The rates of both AD and MID increase dramatically with age, leading to coexisting pathologies with intermingled symptomatology [200]. In support to this mixed cases concept are the report of equally increased blood-brain barrier permeability in both AD and MID patients [201] and the accumulation of amyloid -protein in the brain of MID subjects mimicking AD pathology [202]. There exists considerable overlap between AD and MID clinical symptoms, giving rise to a continuum of patients in whom pure AD and pure MID represent the two extreme poles [200].  The elevated homocysteine (Hcy) values found in AD patients [208,209] are reportedly associated with dementia [208,210].

The choroid plexus is the sole site of mammalian brain involved in TTR production [214]. Its synthesis rate by the choroid epithelium is estimated 25 to 100 times higher than that of the liver on a weight basis [215]. As a result, TTR is a major component of CSF, constituting 10 to 25 % of total ventricular proteins [216] conveying up to 80% of intrathecal thyroxine [217]. TTR thus constitutes an hormonal carrierprotein fulfilling important ontogenic and functional properties in mammalian nervous structures, a concept further corroborated by the observation of its increased CSF concentration during the neonatal period [218]. The data imply that choroidal TTR facilitates the uptake of thyroxine from the bloodstream, governing its transport and delivery to brain tissues following a kinetic model developed by Australian workers [219]. In comparison, CSF contains 10 to 100 times lower RBP and retinol concentrations than plasma whilst retinyl esters from dietary origin are virtually absent [220]. Although it has been reported that minute amounts of RBP could be produced within the neuraxis [221], the sizeable proportion of retinol molecules required for brain maturation utilizes the RCC transport system to reach the choroid plexus. The very high receptor binding affinity expressed by neural tissues for RBP molecules [222] is confined within the endothelial cells of the brain microvasculature and within the choroidal epithelial cells, the two primary sites of the mammalian blood-brain barrier [223]. The contrast between high RBP binding affinities and low intrathecal concentrations makes it likely that holo-RBP does not experience significant transchoroidal diffusion, strongly suggesting that its retinol ligand is released in free form and readily taken up by membrane or intracellular receptors of neural cells. The dual TTR production, plasma-derived and choroid-secreted, allows complementary stimulation of brain activities. Thyroid hormones and retinoids indeed function in concert through the mediation of common heterodimeric motifs bound to DNA response elements [224,225]. The data also imply that the provision of thyroid molecules within the CSF works as a relatively stable secretory process, poorly sensitive to extracerebral influences [12] as opposed to the delivery of retinoid molecules whose plasma concentrations are highly dependent on nutritional and/or inflammatory alterations [66]. This last statement is documented by mice experiments [226] and clinical investigations [227] showing that the level of TTR production by the liver operates as a limiting factor for retinol transport. Defective TTR synthesis determines the occurrence of secondary hyporetinolemia which nevertheless results from entirely different kinetic mechanisms in the two quoted studies [226,227].

In the TTR knock-out mice model, holo-RBP molecules are normally synthetized and secreted by the liver but undergo rapid kidney leakage in the absence of stabilizing TTR molecules [228]. Despite very low levels of plasma retinol (about 5 % of wild type), these targeted mutated animals remain healthy and fertile, implying that efficient compensatory mechanisms take place. No such increased urinary output of RBP molecules occurs in malnourished patients who develop in proportion to their declining protein status electroretinographic abnormalities and ocular lesions which are pathognomonic symptoms of vitamin A deficiency [229]. During nutritional rehabilitation of malnourished subjects, the 3 RCC components gradually return to normal ranges even without retinol or carotene supplementation, indicating that the retinyl esters normally sequestered in liver stellate cells mandatorily need diet-induced synthesis of new TTR molecules before undergoing retinol conversion and binding as holo-RBP ligand [227]. The prominent place occupied by TTR in defining distal retinoid bioavailability has been too long unrecognized despite the warning expressing that ” overlooking the crucial role of TTR in vitamin A-metabolism results in unachieved or even misleading conclusions ” [66].

Retinol is a precursor substrate that must undergo a two step oxidation procedure to release firstly retinal and thereafter the two active all-trans- and 13-cis-retinoic acids (RAs) [225,230]. The latter converting steps are regulated by retinaldehyde dehydrogenase (RALDH) enzymes whose major sites of expression are the olfactory bulb, the striatum and the hippocampus [231,232]. The intracellular activities exerted by retinoid compounds are mediated by a large variety of specific receptors among which are cellular-RBP (CRBP), cellular-RA-BP (CRABP), RA-nuclear receptors (RARs) and retinoid X receptors (RXRs), each composed of 3 subtypes [225,232]. Retinol is the rate-limiting determinant of the concentration of both RA derivatives [233], implying that any fluctuation in protein status might entail corresponding alterations in the cellular bioavailability of retinoid compounds, with all the more rapid effects as all-trans-RA has a short biological half-life of less than 1 hr [234]. Because protein malnutrition is a common finding in as much as 50 % of elderly AD and MID patients [235], many of them could well suffer permanent hyporetinolemia still accelerating the declining concentration of retinoid molecules observed over the course of normal ageing [231].  Dietary vitamin A is required to modulate early development of brain structure and differentiation [236] together with neuronal plasticity, memory functioning and neurotransmitter signaling during adulthood [237].

The normal decrease of brain retinoid molecules throughout the ageing process principally affects the above-described major sites of RA synthesis [238], a regressive alteration even more pronounced in AD patients [231]. In murine models, early depletion of retinoids causes deposition of amyloid -peptides [239], initiating the formation of Alzheimer plaques. In aged animals, cognitive and memory deficits are associated with down-regulation of the expression of retinoid receptors which may recover their full activities under RA supplementation [240]. Administration of RA similarly restores expression of proteins involved in the control of amyloidogenic pathways [241]. Along the same preventive line is the demonstration that retinol disaggregates preformed amyloid fibrils, more effectively than does RA [242].  Alternatively, TTR participates in the maintenance of memory and normal cognitive processes during ageing by acting on the retinoid signalling pathway as recently reported on TTR-null knock-out mice model [42,243]. Moreover, TTR may bind amyloid -peptide in vitro, preventing its transformation into amyloid neurofibrils [244].

Protein malnutrition, as assessed by diminished TTR plasma values, causes the elevation of Hcy concentrations [245]. There exists an inverse correlation between both TTR and Hcy parameters, explaining why malnourished elderly persons incur increasing risk of Hcy-depended thrombovascular complications [213]. The defective mechanism is situated at the level of cystathionine–synthase (CS), an enzyme governing the crossroad of remethylation and transsulfuration pathways [246]. Japanese workers have recently provided experimental validation of the metabolic anomaly, showing that rats given methionine (Met)-deprived nutriture manifest depressed CS activity with subsequent elevation of Hcy plasma levels [247]. Among all essential AAs consumed in human nutrition, Met is regarded as the most critically available because its withdrawal from the customary diet causes the deepest negative NB, being almost as great as when a protein-free regimen is ingested [248]. Met is implicated in a large spectrum of metabolic and enzyme activities and participates in the conformation of a large number of molecules of survival importance [213]. Due to the fact that plant products are relatively Met-deficient, vegan subjects are more exposed than omnivorous to develop hyperhomocysteinemia – related disorders [249]. Dietary protein restriction may promote supranormal Hcy concentrations which appears as the dark side of adaptive attempts developed by the malnourished and/or stressed body to preserve Met homeostasis.  Summing up, we assume that the low TTR concentrations reported in the blood [235] and CSF [250] of AD or MID patients result in impairment of their normal scavenging capacity [244] and in the excessive accumulation of Hcy in body fluids [245], hence causing direct harmful damage to the brain and cardiac vasculature. In addition, depressed TTR concentrations indirectly inhibit the multitude of retinoid-dependent cerebral functioning pathways [231,243] allowing the development of amyloidogenic processes [239]. The practical consequences of these findings imply that the correct assessment of nutritional status is recommended in all elderly patients. The mental and cognitive dysfunctions of old age that are not genetically programmed but result from varying energy, protein and vitamin-deficiencies may be substantially prevented and sometimes improved provided that appropriate nutritional measures are undertaken.

CONCLUDING REMARKS  In spite of classical criticisms [3,4], TTR is regarded as a robust and reliable indicator of protein nutritional. Taking into account the gender- and age-specificities, TTR appears as the sole plasma protein reflecting the fluctuations of TBN pools. The relationship linking alterations of TTR plasma levels with body N reserves are documented both in animal models [175] and in human subjects [105,106].  Uncomplicated malnutrition primarily affects the metabolic N pool, reducing protein syntheses and NB to levels compatible with survival, an adaptive response well identified by declining TTR values. In inflammatory disorders, both metabolic and structural N pools participate in varying proportions in the cytokine-induced responses of the stressed body, resulting in TBN shrinking and concomitant depression of TTR concentrations. Abatement of the stressful condition and/or efficient nutritional rehabilitation allows restoration to normal levels of both TBN pools and TTR values following parallel slopes. TTR thus appears as a dynamic index predicting the outcome of the disease. We attached more importance to the trend outlined by its serial appraisal than to any single measurement.  Whatever the causal factor, depletion of TBN reserves attenuates the body’s capacity to mount appropriate immune and repair mechanisms. A number of clinical investigations have advocated the level of plasma TTR as predictor of the length of hospital stay (LOS) and of mortality rate [252, 255]. Not surprisingly, unrecognized malnutrition entails longer LOS, increased number of complications and higher care costs whereas early detection and treatment of high risk patients significantly alleviate the financial burden of hospitalization while improving the prognostic outcome of the patients [252-256]. The last statement is documented by the first prospective and randomized survey showing that reduced morbidity and mortality rates are depending on protein N intake and correlated with rising TTR concentrations [257]. Providing elderly persons with optimal protein nutritional status in order to insure their protection against the risk of neurodeterioration is the last message released by the fascinating TTR plasma protein.

Points to consider:

  1. Protein energy malnutrition has an unlikely causal relationship to carcinogenesis. Perhaps the opposite is true. However, cancer has a relationship to protein energy malnutrition without any doubt.  PEM is the consequence of cachexia, whether caused by dietary insufficiency, inflammatory or cancer.
  2. Protein energy malnutrition leads to hyperhomocysteinemia, and by that means, the relationship of dietary insufficiency of methionine has a relationship to heart disease. This is the significant link between veganism and cardiovascular disease, whether voluntary or by unavailability of adequate source.

1.2 Downsizing of Lean Body Mass is a Key Determinant of Alzheimer’s Disease

Yves Ingenbleek, and Larry H. Bernstein
Journal of Alzheimer’s Disease 44 (2015) 745–754
http://dx.doi.org:/10.3233/JAD-141950

Lean body mass (LBM) encompasses all metabolically active organs distributed into visceral and structural tissue compartments and collecting the bulk of N and K stores of the human body. Transthyretin (TTR) is a plasma protein mainly secreted by the liver within a trimolecular TTR-RBP-retinol complex revealing from birth to old age strikingly similar evolutionary patterns with LBM in health and disease. TTR is also synthesized by the choroid plexus along distinct regulatory pathways. Chronic dietary methionine (Met) deprivation or cytokine-induced inflammatory disorders generates LBM downsizing following differentiated physiopathological processes. Met-restricted regimens downregulate the transsulfuration cascade causing upstream elevation of homocysteine (Hcy) safeguarding Met homeostasis and downstream drop of hydrogen sulfide (H2S) impairing anti-oxidative capacities. Elderly persons constitute a vulnerable population group exposed to increasing Hcy burden and declining H2S protection, notably in plant-eating communities or in the course of inflammatory illnesses. Appropriate correction of defective protein status and eradication of inflammatory processes may restore an appropriate LBM size allowing the hepatic production of the retinol circulating complex to resume, in contrast with the refractory choroidal TTR secretory process. As a result of improved health status, augmented concentrations of plasma-derived TTR and retinol may reach the cerebrospinal fluid and dismantle senile amyloid plaques, contributing to the prevention or the delay of the onset of neurodegenerative events in elderly subjects at risk of Alzheimer’s disease.

Transthyretin and Lean Body Mass in Stable and Stressed State

http://pharmaceuticalintelligence.com/2013/12/01/transthyretin-and-lean-body-mass-in-stable-and-stressed-state/

A Second Look at the Transthyretin Nutrition Inflammatory Conundrum

http://pharmaceuticalintelligence.com/2012/12/03/a-second-look-at-the-transthyretin-nutrition-inflammatory-conundrum/

Stabilizers that prevent transthyretin-mediated cardiomyocyte amyloidotic toxicity

http://pharmaceuticalintelligence.com/2013/12/02/stabilizers-that-prevent-transthyretin-mediated-cardiomyocyte-amyloidotic-toxicity/

Thyroid Function and Disorders

http://pharmaceuticalintelligence.com/2015/02/05/thyroid-function-and-disorders/

Proteomics, Metabolomics, Signaling Pathways, and Cell Regulation: a Compilation of Articles in the Journal http://pharmaceuticalintelligence.com

http://pharmaceuticalintelligence.com/2014/09/01/compilation-of-references-in-leaders-in-pharmaceutical-intelligence-about-proteomics-metabolomics-signaling-pathways-and-cell-regulation-2/

Malnutrition in India, high newborn death rate and stunting of children age under five years

http://pharmaceuticalintelligence.com/2014/07/15/malnutrition-in-india-high-newborn-death-rate-and-stunting-of-children-age-under-five-years/

Vegan Diet is Sulfur Deficient and Heart Unhealthy

http://pharmaceuticalintelligence.com/2013/11/17/vegan-diet-is-sulfur-deficient-and-heart-unhealthy/

How Methionine Imbalance with Sulfur-Insufficiency Leads to Hyperhomocysteinemia

http://pharmaceuticalintelligence.com/2013/04/04/sulfur-deficiency-leads_to_hyperhomocysteinemia/

Amyloidosis with Cardiomyopathy

http://pharmaceuticalintelligence.com/2013/03/31/amyloidosis-with-cardiomyopathy/

Advances in Separations Technology for the “OMICs” and Clarification of Therapeutic Targets

http://pharmaceuticalintelligence.com/2012/10/22/advances-in-separations-technology-for-the-omics-and-clarification-of-therapeutic-targets/

Sepsis, Multi-organ Dysfunction Syndrome, and Septic Shock: A Conundrum of Signaling Pathways Cascading Out of Control

http://pharmaceuticalintelligence.com/2012/10/13/sepsis-multi-organ-dysfunction-syndrome-and-septic-shock-a-conundrum-of-signaling-pathways-cascading-out-of-control/

Automated Inferential Diagnosis of SIRS, sepsis, septic shock

http://pharmaceuticalintelligence.com/2012/08/01/automated-inferential-diagnosis-of-sirs-sepsis-septic-shock/

 

 

1.3 Transthyretin Blocks Retinol Uptake and Cell Signaling by the Holo-Retinol-Binding Protein Receptor STRA6

Daniel C. Berry, Colleen M. Croniger, Norbert B. Ghyselinck, Noa Noya
Vitamin A is secreted from cellular stores and circulates in blood bound to retinol-binding protein (RBP). In turn, holo-RBP associates in plasma with transthyretin (TTR) to form a ternary RBP-retinol-TTR complex. It is believed that binding to TTR prevents the loss of RBP by filtration in the kidney. At target cells, holo-RBP is recognized by STRA6, a plasma membrane protein that serves a dual role: it mediates uptake of retinol from extracellular RBP into cells, and it functions as a cytokine receptor that, upon binding holo-RBP, triggers a JAK/STAT signaling cascade. We previously showed that STRA6-mediated signaling underlies the ability of RBP to induce insulin resistance. TTR blocks the ability of holo-RBP to associate with STRA6 and thereby effectively suppresses both STRA6-mediated retinol uptake and STRA6-initiated cell signaling. Consequently, TTR protects mice from RBP-induced insulin resistance, reflected by reduced phosphorylation of insulin receptor and glucose tolerance tests. The data indicate that STRA6 functions only under circumstances where the plasma RBP level exceeds that of TTR and demonstrate that, in addition to preventing the loss of RBP, TTR plays a central role in regulating holo-RBP/STRA6 signaling.

1.4 Transthyretin Amyloidosis

1.4.1 (Adapted from a Review in Amyloid: Int J Exp Clin Invest 3:44-56, 1996)

While it was expected that variations in clinical presentation (FAP-I, II, III, IV) were the result of heterogeneity in etiology or pathogenesis of the hereditary amyloidosis, it was not until the discovery by Costa, et al., in 1978 showing transthyretin as a constituent of the fibril deposits, that the biochemical basis of these syndromes could be pursued (Costa, et al., 1978).  This resulted in the discovery of the first variant form of transthyretin mutation reported in 1983.  In 1989 there were approximately 12 known mutations and in 2002 there are at least 90.  Over 80 of these mutations are associated with amyloidosis.  In addition, there is evidence that normal transthyretin may for amyloid especially in the heart and be the basis for senile cardiac amyloidosis (Westermark, 1990).

The transthyretin amyloidoses by definition are all associated with tissue deposits of fibrils having transthyretin as a major protein constituent.  While there are a number of other constituents of the amyloid deposits, including proteoglycan, amyloid P component, and various lipoproteins, it is transthyretin that is the essential ingredient in this type of amyloid.

It would appear that the signals for down regulating production of transthyretin (cytokines such as IL1 and IL6) are the same as those which cause the positive acute phase response of serum amyloid A and C reactive protein (Costa, et al., 1986).  The negative acute phase phenomenon of transthyretin is used by clinicians to monitor nutritional status of their patients.

Transthyretin is firmly entrenched in the phylogenetic evolution of vertebrate species being present in both birds and reptiles and its primary structure has been stable throughout evolution (Richardson, 1994).

While plasma transthyretin is predominantly synthesized by the adult liver, it is also synthesized by the choroids plexus of the brain and mRNA is also present in the retinal pigment epithelium, pituitary and pancreas19, 20 .  Choroid plexus synthesis would appear to be necessary for the thyroid hormone across the basement membrane into the cerebral spinal space.

The binding of RBP to transthyretin saves this small protein (21,000 daltons) from plasma clearance via filtration in the kidney.  However, when the complex gives up retinal, RBP dissociates from transthyretin and goes to meet its fate.  Transthyretin evidently can recirculate to bind more RBP-vitamin A.  Plasma residence time of transthyretin is approximately 20-24 hours, representing a plasma half-life of no more than 15 hours  (Benson, et al., 1996).  This is really very rapid turnover for a plasma protein, compared to plasma residence time of apolipoprotein AI which is 5 days, and that of albumin which is approximately 27 days (t ½ =19 days).

Most variants of transthyretin are not associated with amyloidosis.  Most variants of transthyretin are not associated with any postulated “hot spots” in the coding region.  The Ser6 variant is the only known polymorphism, prevalence of approximately 12% in the Caucasian population.  All the other mutations are present in less than 2% of the population, except in the restricted areas of Northern Sweden where greater than 2% of inhabitants have the Met30 gene and in African Americans, when considered as a group, where approximately 3% have a Val122Ile mutation.  One possible explanation of the large number of pathogenic mutations in transthyretin is that the amyloidosis is a delayed onset disease and, therefore, there is a lessened degree of selection against perpetuation of a pathogenic mutation.

Variations on the theme include the involvement of the vitreous of the eye in a number of the kindreds.  Approximately a third of transthyretin mutations are associated with vitreous deposits of amyloid; however, this finding is not uniform within families.  In different kindreds, a single mutation may have different presentations.  Most notably, Swedish patients with Met30 transthyretin have a high incidence of vitreous opacities with presentation at a fairly advanced age (58 years); whereas Portuguese patients have a lower incidence of vitreous opacities, but have presentation of neuropathy at an early age (mean 32 or 33 years).  Some transthyretin variants present as pure cardiomyopathy (e.g. Met111) (Frederikson, et al., 1962).   The Indiana/Swiss kindred (Ser84) has 100% incidence of cardiomyopathy (Benson and Dwulet, 1983) and this also appears to be true for the Appalachian kindred (Ala60) (Benson, et al., 1987).

Significant renal amyloidosis is less common than cardiac amyloidosis in most of the kindreds.  Recently attention has been directed toward kindreds having transthyretin amyloidosis with extensive leptomeningeal amyloid.  This is the hallmark of the Ohio kindred with oculoleptomeningeal amyloidosis (Gly30) (Goren, et al., 1980; Peterson, et al., 1997) and a recently reported kindred from Hungary (Gly18) in which the first clinical manifestation is dementia (Vidal, et al.,1996).  The His69 mutation has been associated with vitreous opacities alone (Zeldenrust, et al., 1994), but in another family causes oculoleptomeningeal amyloidosis.   Features of the disease in particular kindreds make familiarity with the different clinical expressions of the various transthyretin variants essential.

1.4.2 An insight to the conserved water mediated dynamics of catalytic His88 and its recognition to thyroxin and RBP binding residues in human transthyretin

Avik Banerjeea & Bishnu P. Mukhopadhyaya
http://dx.doi.org:/10.1080/07391102.2014.984632

Human transthyretin (hTTR) is a multifunctional protein involved in several amyloidogenic diseases. Besides transportation of thyroxin and vitamin-A, its role towards the catalysis of apolipoprotein-A1 and Aβ-peptide are also drawing interest. The role of water molecules in the catalytic mechanism is still unknown. Extensive analyses of 14 high-resolution X-ray structures of human transthyretin and MD simulation studies have revealed the presence of eight conserved hydrophilic centres near its catalytic zone which may be indispensable for the function, dynamics and stability of the protein. Three water molecules (W1, W2 and W3) form a cluster and play an important role in the recognition of the catalytic and RBP-binding residues. They also induce the reorganisation of the His88 for coupling with other catalytic residues (His90, Glu92). Another water molecule (W5) participate in inter-monomer recognition between the catalytic and thyroxin binding sites. The rest four water molecules (W6, W*, W# and W†) form a distorted tetrahedral cluster and impart stability to the catalytic core of hTTR. The conserved water mediated recognition dynamics of the different functional sites may provide some rational clues towards the understanding of the activity and mechanism of hTTR.

1.4.3 Amyloid Formation by Human Carboxypeptidase D Transthyretin-like Domain under Physiological Conditions*

Javier Garcia-Pardo, Ricardo Graña-Montes, Marc Fernandez-Mendez, et al.

Proteins can form amyloid aggregates from initially folded states. The transthyretin-like domain of human carboxypeptidase D forms amyloid aggregates without extensive unfolding. The monomeric transthyretin fold has an inherent propensity to aggregate due to the presence of preformed amyloidogenic structural elements. Generic aggregation from initially folded states would have a huge impact on cell proteostasis.

1.5 Evolutionary changes to transthyretin: evolution of transthyretin biosynthesis Samantha J. Richardson
FEBS Journal 276 (2009) 5342–53
http://dx.doi.org:/10.1111/j.1742-4658.2009.07244.x

Thyroid hormones are involved in growth and development, particularly of the brain. Thus, it is imperative that these hormones get from their site of synthesis to their sites of action throughout the body and the brain. This role is fulfilled by thyroid hormone distributor proteins. Of particular interest is transthyretin, which in mammals is synthesized in the liver, choroid plexus, meninges, retinal and ciliary pigment epithelia, visceral yolk sac, placenta, pancreas and intestines, whereas the other thyroid hormone distributor proteins are synthesized only in the liver. Transthyretin is synthesized by all classes of vertebrates; however, the tissue specificity of transthyretin gene expression varies widely between classes. This review summarizes what is currently known about the evolution of transthyretin synthesis in vertebrates and presents hypotheses regarding tissue-specific synthesis of transthyretin in each vertebrate class.

1.6  Distinctive binding and structural properties of piscine transthyretin

C Folli, N Pasquato, I Ramazzina, R Battistutta, G Zanotti, R Berni
FEBS Letters 555 (2003) 279-284
http://dx.doi.org:/10.1016/S0014-5793(03)01248-1

The thyroid hormone binding protein transthyretin (TTR) forms a macromolecular complex with the retinol-specific carrier retinol binding protein (RBP) in the blood of higher vertebrates. Piscine TTR is shown here to exhibit high binding affinity for L-thyroxine and negligible affinity for RBP. The 1.56 Ang resolution X-ray structure of sea bream TTR, compared with that of human TTR, reveals a high degree of conservation of the thyroid hormone binding sites. In contrast, some amino acid di¡erences in discrete regions of sea bream TTR appear to be responsible for the lack of protein-protein recognition, providing evidence for the crucial role played by a limited number of residues in the interaction between RBP and TTR. Overall, this study makes it possible to draw conclusions on evolutionary relationships for RBPs and TTRs of phylogenetically distant vertebrates.

1.7 Protein  Synthesis  at the Blood-Brain Barrier: The Major Proteins  Ecreted By Amphibian Choroid Plexus Is A Lipocalin

  1. Achen, PJ. Harms, T Thomas, SJ. Richardson, REH. Wettenhall, G Schreiber J Biol Chemistry Nov 1992; 267(32): 23167-70Among the proteins secreted by choroid plexus of vertebrates, one protein is much more  abundant than all others. In  mammals, birds, and reptiles  this protein is transthyretin, a tetramer of identical 15-kDa sub- units. In this study choroid plexus from frogs, tadpoles, and toads incubated in  vitro were found to synthesize and secrete one predominant protein. However, this consisted of one single 20-kDa polypeptide chain. It was expressed throughout  amphibian metamorphosis. Part of its amino acid sequence was determined and used for construction of oligonucleotides for polymerase chain reaction. The amplified DNA was used to screen a toad choroid plexus cDNA library. Full-length cDNA clones were isolated and sequenced. The derived amino acid sequence for the encoded protein was 183 amino acids long, including a 20-amino acid preseg- ment. The calculated molecular weight of the mature protein was 18,500. Sequence comparison with other proteins showed that the protein belonged to the lipocalin superfamily. Its expression was highest in choroid plexus, much lower in other brain areas, and absent from liver.  Since no transthyretin was detected in proteins secreted from amphibian choroid plexus, abundant synthesis and secretion of transthyretin in choroid plexus must have  evolved only after the stage of the amphibians.

2 Vitamin A

2.1 Retinoic acid pathways and cancer

2.1.1 Vitamin A, Cancer Treatment and Prevention: The New Role of Cellular Retinol Binding Proteins

Elena Doldo,Gaetana Costanza,Sara Agostinelli,Chiara Tarquini, et al.
BioMed Research International 2015; Article ID 624627, 14 pages
http://dx.doi.org/10.1155/2015/624627

Retinol and vitamin A derivatives influence cell differentiation, proliferation, and apoptosis and play an important physiologic role in a wide range of biological processes. Retinol is obtained from foods of animal origin. Retinol derivatives are fundamental for vision, while retinoic acid is essential for skin and bone growth. Intracellular retinoid bioavailability is regulated by the presence of specific cytoplasmic retinol and retinoic acid binding proteins (CRBPs and CRABPs). CRBP-1, the most diffuse CRBP isoform, is a small 15KD acytosolic protein widely expressed and evolutionarily conserved in many tissues. CRBP-1 acts as chaperone and regulates the uptake, subsequent esterification, and bioavailability of retinol. CRBP-1 plays a major role in wound healing and arterial tissue remodeling processes. In the last years, the role of CRBP-1-related retinoid signaling during cancer progression became object of several studies. CRBP-1 downregulation associates with a more malignant phenotype in breast, ovarian, and nasopharyngeal cancers.Reexpression of CRBP-1 increased retinol sensitivity and reduced viability of ovarian cancer cells in vitro. Further studies are needed to explore new therapeutic strategies aimed at restoring CRBP-1-mediated intracellular retinol trafficking and the meaning of CRBP-1 expression in cancer patients’ screening for a more personalized and efficacy retinoid therapy.

Metabolism of Retinol and Its Derivatives. Vitamin A can be acquired from the diet either as preformed vitamin A (primarily as retinyl ester, retinol, and in much smaller amount as retinoic acid) or provitamin A carotenoids (Figure1). Dietary retinyl esters are converted to retinol within the lumen of the small intestine or the intestinal mucosa and then reesterified to form retinyl ester (RE) within the enterocyte [1]. Provitamin A carotenoids, absorbed by the mucosal cells, are converted first to retinaldehyde and then to retinol [1]. After secretion of the nascent chylomicrons into the lymphatic system, the bulk of dietary vitamin A is taken up by hepatocytes and hydrolyzed again.The free retinol binds the epididymal retinoic acid binding protein (ERABP) and the retinol binding protein (RBP) [2] and into plasma transthyretin. Free retinol can be transferred to hepatic stellate cells for storage. Hepatocytes and hepatic stellate cells are very rich in retinyl ester hydrolases and in cellular retinol binding protein type 1 (CRBP-1). CRBP-1 is necessary to solubilize retinol in the aqueous environment of the cell [1].

Intracellular Trafficking of Retinoids. A cell-surface receptor named stimulated by retinoic acid 6 (STRA6) mediates vitamin A uptake from RBP [3]. Intracellular retinoid bioavailability is regulated by the presence of specific cytoplasmic retinol and retinoic acid binding proteins, CRBPs and CRABPs (Figure2). In the cytoplasm vitamin A and derivatives are bound to cytoplasmic proteins: cellular retinol binding proteins (CRBPs) which comprised four isoforms, CRBP-1 and CRBP-2 and CRBP-3 and CRBP-4. CRBP-1, are the most represented isoform in many tissues. Cellular retinoic acid binding proteins (CRABPs) comprised two isoforms, CRABP-1 and CRABP-2. CRBPs specifically bind retinol, while CRABPs and well-characterized members of the fatty acid binding proteins (FABPs) bind retinoic acid (RA). These proteins control the availability of ligands and determine the physiological response of cells and tissues to vitamin A [4]. Cellular retinoic acid binding proteins may regulate the interactions between retinoic acids and their nuclear receptors by regulating the concentrationof present retinoic acids [5]. Retinoids can activate gene expression by specific nuclear retinoid acid receptors. Two distinct classes of nuclear proteins, the retinoic acid receptors (RARs), and the retinoid X receptors (RXRs) have been identified. Each class consists of 𝛼, 𝛽,and 𝛾 subtypes. RARs and RXRs form either homodimers or heterodimers and function as transacting nuclear transcriptional factors [6]. RAR can be activated by both all-trans and 9-cis RA, whereas RXR is only activated by 9-cis-RA.

2.1.2 Retinoids, retinoic acid receptors, and cancer.

Tang XH1, Gudas LJ.
Annu Rev Pathol. 2011; 6:345-64
http://dx.doi.org:/10.1146/annurev-pathol-011110-130303

Retinoids (i.e., vitamin A, all-trans retinoic acid, and related signaling molecules) induce the differentiation of various types of stem cells. Nuclear retinoic acid receptors mediate most but not all of the effects of retinoids. Retinoid signaling is often compromised early in carcinogenesis, which suggests that a reduction in retinoid signaling may be required for tumor development. Retinoids interact with other signaling pathways, including estrogen signaling in breast cancer. Retinoids are used to treat cancer, in part because of their ability to induce differentiation and arrest proliferation. Delivery of retinoids to patients is challenging because of the rapid metabolism of some retinoids and because epigenetic changes can render cells retinoid resistant. Successful cancer therapy with retinoids is likely to require combination therapy with drugs that regulate the epigenome, such as DNA methyltransferase and histone deacetylase inhibitors, as well as classical chemotherapeutic agents. Thus, retinoid research benefits both cancer prevention and cancer treatment.
2.1.3 Molecular pathways: current role and future directions of the retinoic acid pathway in cancer prevention and treatment.

Connolly RM1Nguyen NKSukumar S.
Clin Cancer Res. 2013 Apr 1; 19(7):1651-9
http://dx.doi.org:/10.1158/1078-0432.CCR-12-3175

Retinoids and their naturally metabolized and synthetic products (e.g., all-trans retinoic acid, 13-cis retinoic acid, bexarotene) induce differentiation in various cell types. Retinoids exert their actions mainly through binding to the nuclear retinoic acid receptors (α, β, γ), which are transcriptional and homeostatic regulators with functions that are often compromised early in neoplastic transformation. The retinoids have been investigated extensively for their use in cancer prevention and treatment. Success has been achieved with their use in the treatment of subtypes of leukemia harboring chromosomal translocations. Promising results have been observed in the breast cancer prevention setting, where fenretinide prevention trials have provided a strong rationale for further investigation in young women at high risk for breast cancer. Ongoing phase III randomized trials investigating retinoids in combination with chemotherapy in non-small cell lung cancer aim to definitively characterize the role of retinoids in this tumor type. The limited treatment success observed to date in the prevention and treatment of solid tumors may relate to the frequent epigenetic silencing of RARβ. Robust evaluation of RARβ and downstream genes may permit optimized use of retinoids in the solid tumor arena.

Vitamin A is derived from animal and plant food sources and has critical functions in many aspects of human biology. Its natural derivatives and metabolized products (retinoids) such as β-carotene, retinol, retinal, isotetrinoin, all-trans retinoic acid (ATRA), 9-cis retinoic acid, and 13-cis retinoic acid have important roles in cell differentiation, growth, and apoptosis (1). Synthetic retinoids are also available and include bexarotene and fenretinide. In clinical practice, retinoids have a wide range of dermatologic indications including for psoriasis, acneiform, and keratinization disorders (2). Systemic retinoids are approved by the U.S. Food and Drug Administration (FDA) for the treatment of cutaneous T-cell lymphoma (3) and acute promyelocytic leukemia (APL; refs. 4, 5). However, the chemopreventive and therapeutic effects of retinoids in solid tumors remain controversial. Therefore, an overview of the research to date and future directions in this area is the focus of this review.

Retinoic acid and the retinoic acid receptor pathway

Retinoic acids (RA) exert their functions through their specific receptors. The 2 distinct classes of receptors are retinoic acid receptors (RAR) and retinoic X receptors (RXR). Each class contains 3 different subtypes—α, β, and γ (6). ATRA and fenretinide can bind specifically to RARS, 13-cis RA and bexarotene only to RXRS, and 9-cis RA to RARS or RXRS (refs. 1, 5; Table 1). The expression of these receptors is regulated by the receptors themselves, other nuclear receptors such as ERα, or by other subtypes in the same family (5, 7). Upon the binding of ligands, RARs and RXRs form heterodimers and function as ligand-dependent transcription factors to activate their downstream effectors by binding to the retinoic acid response elements (RARE) located in the 5′-region of RA downstream genes (5). The above model of RAR or RXR function via binding to RARE is considered the RA classical or genomic pathway. Activation of the classical pathway will trigger cell differentiation, cell arrest, and eventual apoptosis (8).

Table 1. Select clinical trials evaluating retinoids in solid tumors

Retinoid Other names Target Clinical trial setting
ATRA Tretinoin RAR Advanced NSCLC Phase II randomized (n = 107)
13-cis RA Isotretinoin Roaccutane Accutane RXR Primary prevention: H+N cancer
Advanced solid tumorsPhase I (n = 13)
Metastatic breast cancer Phase II randomized (n = 99)
9-cis RA Alitretinoin RAR RXR Metastatic breast cancerPhase I (n = 12)
Fenretinide 4-OH Phenylretinamide RAR Primary prevention: women at high risk of breast cancer Randomized double-blind 2 × 2 design (n = 235)
Secondary prevention: early breast cancerPhase III randomized (n = 2,867)
Bexarotene RXR Chemotherapy-naïve advanced NSCLC Phase III randomized (n = 623)
Metastatic  breast cancer Phase II single arm (n = 148)

The function of RA and its receptors involves not only the classical pathway but also multiple other important pathways. RAs have been shown to regulate NF-κB (9), IFN-γ (10), TGF-β (11), VEGF (12), mitogen-activated protein kinase (MAPK; ref. 13), and chromatin remodeling (14). Furthermore, RARs and RXRs can form heterodimers with other types of receptors, including the estrogen receptor-α (ERα; refs. 7, 15), AP-1 receptor (16), peroxisome proliferator-activated receptor (PPAR; ref. 17), liver X receptors (LXR; refs. 18, 19), and vitamin D receptor (VDR; ref. 20; Fig. 1). When RARs/RXRs heterodimerize with these receptors, they are involved in regulating their partner receptor’s pathways, referred to as nonclassical or nongenomic pathways (5). Interestingly, these pathways often regulate processes that have functions opposite to the classical pathway. For example, a study has shown that RA activation of the PPARβ/δ pathway resulted in upregulation of prosurvival genes (17), contrary to the known differentiation function of RARs and RXRs in response to RA. The function of RAs, which involves nongenomic pathways, may provide opportunities for cancer cells to develop resistance to RA treatment, discussed later in this review. Another important function of RARA is the regulation of stem cell differentiation (11). RAs target stem cells via both genomic and nongenomic pathways such as the Notch pathway and inflammation (10, 11). In summary, RAs and their receptors play important roles as regulators of critical processes in cells.

RARs and their action

RARs and their action

The RARs and their action. In a series of enzymatic steps, vitamin A (retinol) is metabolized through the oxidizing action of retinaldehyde (RDH) to retinal, and by retinaldehyde dehydrogenase (RALDH), to RA. RA has 3 different isomers: all-trans, 9-cis, and 13-cis RA. RA is transported to the nucleus by the protein cellular RA–binding protein (CRABP) and delivered to the RARα. RARα heterodimerizes with and binds to RARE present most often in gene promoters. In the classical pathway of RA action, RA binds to dimers of RARα and RXRs (α, β, or γ) to induce expression of its downstream target genes, including RARβ. Upon activation, RARβ can regulate its own expression and that of its downstream genes, the function of which is mainly to inhibit cell growth. Alternatively, RA can be bound and transported to the nucleus by other factors such as FABP5. This delivers RA to other nonclassical receptors such as PPARβ/δ and ERα which activate nongenomic pathways such as PDK-1/Akt or the ERα pathway. Contrary to the differentiation functions attributed to the classical pathway, the nongenomic pathways exert strong antiapoptotic and proliferative effects on cancer cells. It is believed that the classical and nongenomic pathways are controlled by the relative abundance of their own ligands. RA has a stronger affinity for RARs than for the other receptors, and the classical pathway plays a dominant role over the nongenomic pathways. Thus, if RA is present with other ligands such as estrogen, signaling through the classical pathway is preferred to result in cell differentiation and growth inhibition.

http://clincancerres.aacrjournals.org/content/19/7/1651/F1.small.gif

Retinoids and cancer

The retinoids have been investigated extensively for the prevention and treatment of cancer, predominantly because of their ability to induce cellular differentiation and arrest proliferation. RA-regulated tumor suppressor genes, when expressed, can inhibit tumor growth (21). Among the 3 RARs, RARβ has been well known for its tumor-suppressive effects in epithelial cells (5822). Exogenous expression of the RARβ gene can cause RA-dependent and -independent apoptosis and growth arrest (23). RARβ-induced growth arrest and apoptosis is mediated through RARα (24). As RA ligand-bound RARα binds to the RARE on the RARβ promoter, multiple activator proteins assemble at the site and result in the upregulation of the RARβ gene (5). The expression of RARβ results in the transactivation and expression of a number of its target genes that mediate cell differentiation and death (5, 68). The ability of ATRA to initiate differentiation of promyelocytic leukemic cells to granulocytes is the basis of the dramatic success of retinoic acid therapy for acute promyelocytic leukemia harboring the RAR/PML translocation (4) and confirms the important role of RARβ in tumor growth inhibition. It is also becoming increasingly clear that RARβ expression is lost early in carcinogenesis or is epigenetically silenced (25) in many solid tumors, providing an opportunity for novel treatment strategies to be investigated using retinoids together with epigenetic modifiers that promote reexpression of silenced genes, described further below.

The retinoids have an established role in the treatment of certain hematologic malignancies, with FDA approval for use in cutaneous T-cell lymphoma and APL. Bexarotene (an RXR-selective retinoid or rexinoid) is associated with an overall response rate of approximately 50% in patients with refractory advanced-stage mycosis fungoides, a cutaneous T-cell lymphoma (3). ATRA, a synthetic retinoid, exhibited improvements in disease-free and overall survival when compared with chemotherapy alone in APL, with long-term remissions occurring in almost 70% of cases (4). The success of retinoids in treating this disease relates to the underlying chromosomal translocation and production of the PML/RARα fusion protein and the ability of retinoids to induce differentiation and inhibition of cell growth in this setting (26, 27). Clinical trials investigating the role of retinoids in the prevention and treatment of solid tumors will now be outlined with a focus on cancers of the upper aerodigestive tract (oropharyngeal and lung) and breast (Table 1).

2.1.4 Retinoid Pathway and Cancer Therapeutics

Nathan Bushue and Yu-Jui Yvonne Wan
Adv Drug Deliv Rev. 2010 Oct 30;  62(13): 1285–1298.
http://dx.doi.org/10.1016%2Fj.addr.2010.07.003

The retinoids are a class of compounds that are structurally related to vitamin A. Retinoic acid, which is the active metabolite of retinol, regulates a wide range of biological processes including development, differentiation, proliferation, and apoptosis. Retinoids exert their effects through a variety of binding proteins including cellular retinol binding protein (CRBP), retinol-binding proteins (RBP), cellular retinoic acid-binding protein (CRABP), and nuclear receptors i.e. retinoic acid receptor (RAR) and retinoid × receptor (RXR). Because of the pleiotropic effects of retinoids, understanding the function of these binding proteins and nuclear receptors assists us in developing compounds that have specific effects. This review summarizes our current understanding of how retinoids are processed and act with the emphasis on the application of retinoids in cancer treatment and prevention.

Vitamin A and its derivatives (retinoids) exert a wide range of effects on embryonic development, cell growth, differentiation, and apoptosis. Vitamin A has been used as a treatment for thousands of years. The Egyptian papyruses Kahun 1 (ca. 1825 B.C.) and Ebers (ca. 1500 B.C.) described how the liver was used to cure eye diseases such as night blindness. Greek scholar Hippocrates (460-327 B.C.) described in the second book of “Prognostics” a method for curing night blindness: “raw beef liver, as large as possible, soaked in honey, to be taken once or twice by mouth.” Chinese medicine used pigs’ liver as a remedy for night blindness, as described by Sun-szu-mo (7th century A.D.) in his “1000 Golden Remedies”. Given that the liver is where the body stores excess vitamin A, the liver represents the best source of vitamin A available for treatment in the pre-pharmaceutical world.

The effect of vitamin A on growth was first described in a mouse experiment done by G. Lunin (1881) [2], in which one group of mice was fed pure casein, fat, sucrose, minerals, and water, and another group was fed whole dried milk. The milk-fed group was healthy and grew normally, while the other group was sick and ultimately died. Thus, something in milk was essential for survival. Elmer McCollum at University of Wisconsin-Madison as well as Lafayette Mendel and Thomas Burr Osborne at Yale University independently discovered vitamin A. McCollum began his study in 1907 by feeding cows hay with wheat, oats, or yellow maize.

Wheat-fed cows did not thrive, became blind and gave birth to dead calves prematurely. Oat-fed cows fared somewhat better, but the yellow maize-fed cows were in excellent condition, produced vigorous calves, and had no miscarriages. McCollum postulated that performing the same nutritional study using small animals, such as rodents, which require less food, provide faster reproduction and experimental outcome. Using rats, he found a diet of pure protein, pure milk sugar, minerals, and lard (or olive oil) inhibited growth, while addition of butterfat or an ether extract of egg yolk to the diet restored health. Thinking that he had found a fat-soluble factor that promoted growth in rats, he saponified butterfat, extracted the unsaponifiable mixture into ether, and added the extract to oliveoil and that extract could support growth. This essential component to support growth and development was named “fat-soluble factor A,” and later renamed vitamin A [1].

There are over 4,000 natural and synthetic molecules structurally and/or functionally related to vitamin A. Vitamin A cannot be synthesized by any animal species and is only obtained through diet in the form of retinol, retinyl ester, or β-carotene (Figure 1). Ingested vitamin A is stored as retinyl esters in hepatic stellate cells. Retinol is reversibly oxidized by retinol dehydrogenases to yield retinal. Subsequently, retinal may be irreversibly oxidized to all-trans retinoic acid (all-trans RA) by retinal dehydrogenases and further oxidized by cytochrome P450 enzymes (mainly CYP26) in hepatic tissue. Retinol has six biologically active isoforms that include all-trans, 11-cis, 13-cis, 9, 13-di-cis, 9-cis, and 11, 13-di-cis, with all-trans being the predominant physiological form. Endogenous retinoids with biological activity include all-trans RA, 9-cis RA, 11-cis retinaldehyde, 3,4-didehydro RA, and perhaps 14-hydroxy-4, 14-retro retinol, 4-oxo RA, and 4-oxo retinol [35]. All-trans RA isomerizes under experimental and physiological conditions. Different isomers activate different receptors and thus lead to different biological effects. RAs designed to be receptor specific can improve efficacy and avoid unwanted side effects. Retinoids that specifically bind to RXR are called rexinoids and have been effective in cancer treatment. Retinoids are comprised of three units: a bulky hydrophobic region, a linker unit, and a polar terminus, which is usually a carboxylic acid. Modification of each unit has generated many more compounds. Please refer to recent reviews [68].

2.1.4.1 Retinoid Pathway 

Retinoid Pathway  nihms229611f1

Retinoid Pathway nihms229611f1

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991380/bin/nihms229611f1.jpg

Retinoids absorbed from food are converted to retinol and bound to CRBP in the intestine. Then, retinol is converted to retinyl esters and enters into blood circulation. The liver up takes retinyl esters, which are converted to retinol-RBP complex in the hepatocyte. In the serum, the retinol-RBP complex is bound to transthyretin (TTR) in a 1:1 ratio to prevent elimination by the kidney and to ensure retinol is delivered to the target cell. The uptake of retinol by the target cell is mediated by a trans-membrane protein named “stimulated by retinoic acid 6” (STRA6), which is a RBP receptor. In the target cell, retinol either binds to CRBP or is oxidized to retinaldehyde by retinol dehydrogenase (RDH) in a reversible reaction. Then, retinaldehyde can be oxidized by retinaldehyde dehydrogenase (RALDH) to RA. In the target cell, RA either binds to CRABP or enters the nucleus and binds to nuclear receptors to regulate gene transcription. Alternatively, RA can mediate via nongenomic mechanism and regulate cellular function. Hepatocytes not only process retinoids, but also are the target cells. In addition, hepatocytes located next to the storage site (stellate cell). Thus, retinoid-mediated signaling must have a profound effect in regulating hepatocyte function and phenotype [36190191].

2.1.4.2 Retinoid Binding Proteins

There are various types of retinoid-binding proteins, which locate in intracellular and extracellular compartments and associate with isomeric forms of retinoids. Hence, retinoids are either associated with cellular membranes or bound to a specific retinoid binding protein. These binding proteins along with nuclear receptors mediate the action of retinoids. Their interactions are summarized in figure 1. Retinoid-binding proteins solubilize and stabilize retinoids in aqueous spaces. In addition to this general role, specific retinoid-binding proteins have distinct functions in regulating transport and metabolism of specific retinoids. For example, the parent vitamin A molecule, all-trans retinol, circulates in blood bound to serum retinol binding protein (RBP). Inside the cells, all-trans retinol and its oxidation product, all-trans retinal, are associated with different isoforms of cellular retinol-binding proteins (CRBP), while all-trans RA intracellularly binds to cellular retinoic acid-binding protein isoforms (CRABP).

2.1.4.3 RBP

Retinol is secreted from its storage pools and circulates in blood by binding to RBP. The main storage site for vitamin A and the main site of synthesis of RBP is the liver, although other tissues (including adipose tissue, kidney, lung, heart, skeletal muscle, spleen, eye and testis) also express this protein. Secretion of RBP from the liver is regulated by the availability of retinol [9]. Vitamin A deficiency inhibits RBP secretion, leading to protein accumulation in the endoplasmic reticulum of hepatic parenchymal cells. In the presence of retinol, RBP associates with retinol, moves to the Golgi apparatus and is secreted into blood. The mechanism by which retinol initiates RBP secretion from cells is not known. In blood, RBP is bound to the small protein transthyretin, which in addition to associating with RBP functions as a carrier protein for thyroid hormones. Binding of RBP to transthyretin prevents the loss of this smaller protein by filtration in the renal glomeruli. The transthyretin-RBP-retinol complex transports retinol in the circulation and delivers it to target tissues [10].

Important insights into the biological role of RBP have been obtained by studies of mice and humans in which the RBP gene is disrupted. RBP-deficient mice display both reduced blood retinol levels and impaired visual function during the first months of life. When maintained on a vitamin A-sufficient diet, they acquire normal vision by 5 months of age, even though their blood retinol level remains low. A striking phenotype of the RBP-null mice is that they possess larger than normal hepatic vitamin A storage, but are dependent on a continuous dietary intake of vitamin A [11], further proving the importance of RBP as a transporting protein. A study of two human siblings that harbored point mutations in their RBP gene and exhibited undetectable plasma RBP levels revealed that these sisters suffered from night blindness and mild retinal dystrophy but did not exhibit other clinical symptoms of vitamin A deficiency [12]. Taken together, RBP is critical for the mobilization of retinol from hepatic storage pools; however, RBP is not essential for the delivery of retinol to target tissues. Supply of vitamin A to target tissues in the absence of RBP is likely to be accomplished via newly absorbed retinyl esters or β-carotene present in circulating chylomicrons. Increased RBP has been shown to contribute to insulin resistance and type 2 diabetes [11]. All-trans RA has recently been shown to increase insulin sensitivity in diabetic mice while lowering RBP [13]. The effect on binding proteins must be considered when retinoids are used for disease treatment.

2.1.4.4 SRA6

The stimulated by retinoic acid gene 6 (STRA6) encodes the cell surface RBP receptor, which binds specifically to RBP and mediates retinol uptake from holo-RBP [14]. STRA6 is a widely expressed transmembrane protein. In mouse mammary epithelial cells, STRA6 expression can be up regulated by Wnt1 and retinoids. In addition, STRA6 mRNA levels are up regulated in mouse mammary gland tumors and human colorectal tumors [15]. Importantly, while the RBP-null mice and humans give rise to relative mild phenotypes, STRA6-null mice develop anophthalmia, congenital heart defects, diaphragmatic hernias, alveolar capillary dysplasia, lung hypoplasia, and mental retardation. These findings suggest that STRA6 may have additional functions that are not related to RBP transport [16].

2.1.4.5 CRBP

CRBPs belong to the family of fatty acid binding proteins in which expression of CRBP family members are tissue specific. For example, CRBP-II is expressed only in the enterocytes of the intestine, while CRBP-I and -III are expressed throughout embryonic and adult tissues [17]. Knockout studies for CRBP isoforms have identified differences in function due to altered tissue localization. CRBP-I knockout mice are healthy. However, they have low levels of hepatic retinyl esters [18], and their hepatic lipid droplets appear to be smaller and less abundant than in wild type littermates. CRBP-II-null mice have impaired retinol uptake, but they develop and reproduce normally under vitamin A-enriched diet, albeit with reduced retinol storage [19]. Reduction of vitamin A in the maternal diet of CRBP-II-null mice during gestation results in neonatal mortality immediately following birth [19]. CRBP-III null mice have impaired vitamin A incorporation into milk, but they are otherwise healthy [20]. CRBP-I and CRBP-III compensate for each other to maintain normal retinoid homeostasis, but the compensation is incomplete during lactation [20]. The binding affinity of CRBP-I towards retinol is about 100-fold higher than that of CRBP-II. They display a similar binding affinity towards retinal and CRBP-II associates with retinol and retinal with similar affinities. CRBPs, and especially CRBP-I with its high affinity for retinol, may sequester retinol from its ability to disrupt cell membranes. Epigenetic silencing of CRBP is a common event in human cancers [21]. Silencing CRBP reduces the availability of retinyl esters in the bloodstream and decreases the body’s ability to metabolize retinol [22].

2.1.4.6 CRABP

CRABP-I and -II have been identified with a high affinity for all-trans RA. In humans, these isoforms display 74 percent sequence identity and are highly conserved among species; however, these CRABP isoforms display different patterns of expression across cells and developmental stages. In adults, CRABP-I is expressed ubiquitously, while CRABP-II is only expressed in the skin, uterus, ovary, and the choroid plexus. Both CRABPs are widely expressed in the embryo, although they do not usually co-exist in the same cells. The biological functions of CRABPs are not completely understood. In mouse knockout stu dies, disruption of either CRABP-I or -II only display mild defects in limb development [23], which suggests CRABPs may be involved in generation of appropriate RA concentration gradients in the developing limb bud. Both CRABP isoforms are present in cytosol and nucleus and thus may deliver the ligand directly to the nuclear receptor. The differential role of these two binding proteins remains to be studied (reviewed in [24] and [25]). Increased CRABP-I expression may also contribute to RA resistance of cancer cells [26]. The effect of CRABP on cancer therapy deserves more attention.

2.1.4.7 Retinoic Acid Receptors

The major breakthrough in understanding RA’s function occurred upon identifying and cloning the receptors for RA [2728]. RA regulates gene expression by binding to its nuclear receptors, which in turn activates transcription of their downstream target genes. Thus, retinoids exert their biological functions primarily by regulating gene expression. This was predicted by Sporn and Roberts in 1983, when they wrote: “Ultimately, it would appear that the problem of the molecular mechanism of action of retinoids in control of differentiation and carcinogenesis is converging on one of the central problems of all biology, the control of gene expression.” [29]

2.1.4.8 RAR and RXR

Two distinct classes of receptors for retinoids have been identified: retinoic acid receptors (RAR) and retinoid × receptors (RXR). Each class of receptor contains three subtypes – α, β, and γ. RARs can be activated by both all-trans and 9-cis-RA, while, RXRs are exclusively activated by 9-cis RA. However, due to the conversion of all-trans to 9-cis RA, high concentrations (10−5 M) of all-trans RA can also activate gene transcription in cells transfected with RXRs [30].

RXRs can form homo- and heterodimers with other receptors. In fact, RXRs are promiscuous receptors forming heterodimers with many different kinds of receptors, which include receptors for fatty acids [peroxisomal proliferator activated receptors (PPAR)], bile acids [farnesoid × receptor (FXR)], oxysterols [liver × receptor (LXR)], xenobiotics [pregnane × receptor (PXR) and constitutive androstane receptor (CAR)], vitamin D [vitamin D receptor (VDR)], and RA (RAR). RXRs can also form homodimers. Hypervitaminosis A leads to bone fracture suggesting that vitamin A and D compete for the same receptor [31]. Within these heterodimers, RXRs can exist as both active and silent partners. When it serves as an active partner, 9-cis RA and the ligand for the heterodimeric partner can activate the heterodimer, and addition both ligands give synergistic induction in gene transcription. For example, RXR is an active partner for PPAR. Similarly, heterodimeric complexes of RXR with LXR or FXR also retain 9-cis RA responsiveness. Thus, RAs can regulate PPAR- and FXR-mediated pathways [32]. Recently, we demonstrated that RAs could also activate PXR-, VDR, and CAR-mediated signaling and thus regulated xenobiotic metabolism and potentially its own oxidation [3335]. When RXR serves as a silent partner, the heterodimer of RXR and its partner does not respond to RA. Regardless of their active or silent role, RXRs must be present in order to exert biological actions of various nuclear receptors. Using hepatocyte RXRα-deficient mice [3637], we have demonstrated that RXRα does play vital roles in xenobiotic (alcohol, acetaminophen) and endobiotic (fatty acid, cholesterol, amino acid, and carbohydrate) metabolism [3340]. Thus, RXR functions as an auxiliary factor and determines the effects of other hormones, making RXR a master regulator. The structure of nuclear receptors is summarized in recent review articles [738].

Existing data suggest that the binding protein and receptor work together to exert the specific effect of RAs. For example, RAs can bind to both PPARβ, the receptor for fatty acids, and RAR. Fatty acid-binding protein 5 (FABP5) and CRABP-II are specific binding proteins that channel RAs from the cytosol into the nucleus for binding to either PPARβ or RAR, respectively [39]. The ratio of FABP5/CRABP-II concentrations determines which receptor is activated. By activating PPARβ, RAs induce expression of genes affecting lipid and glucose homeostasis, such as the insulin-signaling gene pyruvate dehydrogenase kinase 1 (PDK1), which enhances insulin action. Hence, RAs stimulate lipolysis and reduce triglyceride content. RA implantation into obese mice causes up regulation of PPARβ as well as an increased expression of PPARβ target genes, including PDK1, which led to weight loss [40].

2.1.4.9 Retinoids and Cancer

Retinoids are widely used to treat visual and dermatological diseases. Their effect on cancer prevention and treatment has received a lot of attention. This review focuses on the action of retinoids on cancer. Retinoids have been used as potential chemotherapeutic or chemopreventive agents because of their differentiation, anti-proliferative, pro-apoptotic, and anti-oxidant effects. Epidemiological studies show that lower vitamin A intake results in a higher risk of developing cancer, which aligns with observations of vitamin A-deficient animals [61]. Altered expression of RA receptors is also associated with malignant transformation of animal tissues or cultured cells. Furthermore, retinoids suppress carcinogenesis in tumorigenic animal models for skin, oral, lung, breast, bladder, ovarian, and prostate [6268]. In humans, retinoids reverse premalignant human epithelial lesions, induce the differentiation of myeloid cells, and prevent lung, liver, and breast cancer [6973].

The following is a summary of how major retinoids may work in cancer treatment or prevention.

2.1.4.9.1 All-trans RA (tretinoin)

All-trans RA is the most abundant natural retinoid and has been widely studied for many years. It is currently in clinical trials for the treatment of lymphoma, leukemia, melanoma, lung cancer, cervical cancer, kidney cancer, neuroblastoma, and glioblastoma. The most effective clinical usage of all-trans RA in human disease was demonstrated in treatment of a rare leukemia, acute promyelocytic leukemia (APL). APL is characterized by selected expansion of immature myeloid precursors or malignant myeloid cells blocked at the promyelocytic stage of hemopoietic development. APL cells invariably express aberrant fusion proteins involving the DNA and ligand binding domain of RARα [7475]. Other fusion partners include the promyelocytic leukemia zinc finger gene, the nucleophosmin gene, the nuclear mitotic apparatus gene, and the Stat5b gene, while the most common fusion partner is promyelocytic leukemia protein (PML). The PML-RARα chimeric receptor is created by a balanced reciprocal chromosomal translocation, t(15;17)(q22:q11). The expressed PML-RARα chimeric receptor alters normal function of RARs. PML-RARα can form a homodimer through the coiled-coil motif of PML, inhibiting RARα’s ability to bind to RA responsive elements, thereby preventing activation of downstream target genes [7677]. In addition, RXR is an essential component of the oncogenic PML/RARα complex suggesting RXR can be a drug target for APL [7879]. In 1995, the FDA approved all-trans RA for treating APL. The all-trans RA-induced differentiation of APL cells is due to both its ability to promote the degradation of the mutant PML-RARα and the dissociation of its co-repressors [80]. All-trans RA also causes cell cycle arrest at G1 phase and inhibits cell proliferation [81]. In addition, high concentration of all-trans RA induces post-maturation apoptosis of APL-blasts through the induction of the tumor-selective death ligand tumor necrosis factor-related apoptosis-inducing ligand TRAIL [82].

RA syndrome is a life-threatening complication seen in APL patients treated with all-trans RA. This syndrome is characterized by dyspnea, fever, weight gain, hypotension, and pulmonary infiltrates. It can be effectively treated by giving dexamethasone and holding off all-trans RA treatment in severe cases. An elevated white count is sometimes associated with this syndrome, but is not a prerequisite. The etiology of RA syndrome is not clear; several causes have been speculated including a capillary leak syndrome from cytokine release from the differentiating myeloid cells. Alternatively, all-trans RA may cause the maturing myeloid cells to acquire the ability to infiltrate organs such as the lung [83].

2.1.4.9.2. 9-cis RA (alitretinoin)

9-cis RA differentiates itself from all-trans RA in its ability to activate both RAR and RXR. In addition, 9-cis RA activates PPAR, FXR, PXR, VDR, and CAR via RXR. In preclinical studies, 9-cis RA is effective in the prevention of mammary and prostate cancer [8485] and it has also been FDA-approved for the topical treatment of cutaneous lesions of Kaposi’s sarcoma [86]. In addition, 9-cis RA and all-trans RA can individually induce apoptosis of human liver cancer cells [87]. 9-cis RA not only regulates nuclear genes, but also mitochondria gene transcription [88].

2.1.4.9.3. 13-cis RA (isotretinoin)

13-cis RA is unique that it exhibits immunomodulatory and anti-inflammatory responses. It inhibits ornithine decarboxylase, thereby decreasing polyamine synthesis and keratinization [89]. 13-cis RA noticeably reduces the production of sebum and shrinks the sebaceous glands [90]. It stabilizes keratinization and prevents comedones formation [9192]. The exact mechanism of action is unknown. This combination of regulating proliferation, differentiation, and inflammation could make 13-cis RA a more effective drug in comparison to other retinoids, which may cause inflammation and irritation [93].

13-cis RA is in clinical trial for different types of cancers, and thyroid cancer received a lot of attention. In follicular thyroid cancer cells, 13-cis RA induces radioiodine avidity of cells formerly unable to accumulate radioiodine [94]. In human thyroid carcinoma cell lines, retinoids induce the expression of type I iodothyronine-5′-deiodinase and sodium/iodide-symporter, which are the thyroid differentiation markers [95]. However, approximately 30% of thyroid tumors dedifferentiate after treatment and thus develop into highly malignant anaplastic thyroid carcinomas [96]. 13-cis RA is also used to treat non-operable thyroid follicular tumors, which fail to uptake radioiodine. 13-cis RA increases the radioiodide uptake in some patients. The beneficial outcome of this treatment was interpreted as partial re-differentiation of thyroid cancer cells. This effect of 13-cis RA requires the existence of functional RXR [96]. The effect of 13-cis RA on thyroid cancer has been reviewed extensively [97]. Besides thyroid cancer, utilizing 13-cis RA for maintenance therapy has significantly improved the outcome of patients with a high-risk form of neuroblastoma [98]. Along the same line of work, Krüppel zinc-finger protein ZNF423 is critical for RA signaling and is likely a prognostic marker for neuroblastoma [99]. 13-cis RA is also effective in preventing head and neck cancer, which is discussed below.

2.1.4.9.4. Synthetic Retinoids

N-(4-hydroxyphenyl) retinamide (Fenretinide or 4HPR) was first synthesized in the late 1960s by R. W. Pharmaceuticals. Since then, the biological properties of fenretinide have been of great interest. Currently, fenretinide is one of the most promising clinically tested retinoids. The modification of the carboxyl end of all-trans RA with an N-4-hydroxyphenyl group resulted in increased efficacy as a chemoprevention agent as well as reduced toxicity when compared with other retinoids [100]. Animal models have demonstrated that treatment with fenretinide prevents chemically induced cancers of the breast, prostate, bladder, and skin [101104]. Furthermore, the combination of tamoxifen with fenretinide produces efficacy greater than either chemical alone [105].

Natural retinoids like all-trans RA induce differentiation and/or cytostasis in target cells [106108], while fenretinide has distinct biologic effects including the induction of apoptosis by generating reactive oxygen species (ROS) and lipid second messengers [104]. The apoptotic effect of fenretinide has been documented in a variety of cancer cells including transformed T cells, B cells and breast epithelial cells, as well as bladder, breast, cervical, colon, embryonal, esophageal, head and neck, lung, ovarian, pancreatic, prostate, and skin carcinomas [100]. Furthermore, fenretinide does not induce point mutations or chromosomal aberrations, and is therefore not genotoxic [109]. These qualities suggest that fenretinide could be used for a long-term chemopreventive modality. In animal models, fenretinide has demonstrated chemopreventive efficacy against carcinogenesis of the breast [110], prostate, pancreas, and skin [104111112]. Moreover, in a clinical setting, fenretinide slowed the progression of prostate cancer in men diagnosed with an early stage of the disease [113]. Fenretinide protected against the development of ovarian cancer and a second breast malignancy in premenopausal women who had been treated to prevent the progression of early-stage breast cancer [114]. It also prevented relapse and the formation of secondary primary lesions in patients following the surgical removal of oral leukoplakia [115]. Recent studies also illustrated the anti-angiogenic [116] and anti-fibrotic [117] effect of fenretinide. Furthermore, long-term fenretinide treatment prevents high-fat diet-induced obesity, insulin resistance, and hepatic steatosis [118].

The mechanisms associated with fenretinide-induced apoptosis have been explored, but are not well-understood [100]. The components that lead to ROS generation and cause cell death are largely unknown. Depending on cell types and models used, the effect of fenretinide has been shown to be RARβ-dependent or -independent [119]. Our data showed that fenretinide-induced apoptosis of human liver cancer cells was RARβ-dependent [120]. Furthermore, induction and cytoplasmic localization of Nur77 dictates the sensitivity of liver cancer cell to fenretinide-induced apoptosis [121]. It seems that fenretinide enriches the cytoplasmic Nur77 to target mitochondria and induce cell death. The relationship between RARβ and Nur77 in mediating fenretinide-induced apoptosis remains to be determined.

A retinoid-related molecule 6-[3-(1-adamantyl)-4-hydroxyphenyl]-2-naphthalenecar-boxylic acid (AHPN) (also called CD437) and it’s analog (E)-4-[3-(1-adamantyl)-4-hydroxyphenyl]-3-chlorocinnamic acid (3-Cl-AHPC) also have Nur77-dependent apoptotic effects [122124]. AHPN is structurally distinct from fenretinide. AHPN-induced apoptosis activates JNK [125127], which is required for maximal apoptosis induction and precedes mitochondrial depolarization. Induction of apoptosis of breast and prostate cancer cells by AHPN is also associated with its inhibition of Akt activity [128]. Thus, induction of JNK and inhibition of Akt phosphorylation of Nur77 contribute to Nur77 nuclear export mediated by AHPN [129].

While many synthesized RAs are promising for cancer treatment, only a few are FDA-approved or currently undergoing clinical trials for cancer therapy. A number of retinoids, which have been FDA-approved for dermatological purposes, have potential for cancer treatment. Bexarotene (Targretin) is a synthetic retinoid approved by the FDA to treat skin problems caused by cutaneous T-cell lymphoma that are unresponsive to other treatments [130]. Other synthetic retinoids, such as TAC-101 (Taiho Pharmaceutical, Tokyo, Japan) has shown efficacy in inhibiting tumor growth in the liver and markedly increases survival in both the primary HCC and metastatic colon cancer models [131]. TAC-101 is currently in phase II trial for hepatocellular carcinoma and has shown good preliminary success [132]. Another, Tazarotene (AVAGE) (Allergan, Irvine, CA) is in phase I trials for the treatment of lymphoma [133]. Please see table 1 for a brief characterization of some of retinoids that are in use or in clinical trials.

3  Vitamin C

3.1 American Cancer Society

http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/herbsvitaminsandminerals/vitamin-c

Vitamin C is an essential vitamin the human body needs to function well. It is a water-soluble vitamin that cannot be made by the body, and must be obtained from foods or other sources. Vitamin C is found in abundance in citrus fruits such as oranges, grapefruit, and lemons, and in green leafy vegetables, tomatoes, potatoes, strawberries, red or green peppers, and cantaloupe.

Vitamin C is found in many vegetables and fruits, especially oranges, grapefruits, and peppers. Many studies have shown a link between eating foods rich in vitamin C, such as fruits and vegetables, and a reduced risk of cancer. On the other hand, the few studies in which vitamin C has been given as a supplement have not shown a reduced cancer risk.

This suggests that the activity of fruits and vegetables in preventing cancer is due to a combination of many things such as vitamins, fiber, and other phytochemicals and not to vitamin C alone (see Phytochemicals). Clinical trials of high doses vitamin C as a treatment for cancer have not shown any benefit. High doses of vitamin C can cause side effects in some people.

3.2 Intravenous vitamin C for cancer

Oct 4, 2013 | By Dr. Ronald Hoffman

For more than 20 years, the Hoffman Center has been using high-dose vitamin C drips in its cancer support protocols. The initial impetus was from Linus Pauling who, together with Ewan Cameron, pioneered the use of high-dose C in cancer in the 1960s.

Now, there’s new interest in this modality for fighting cancer based on new, exciting research under way at the National Institutes of Health.

Cameron and Pauling found that vitamin C helped cancer patients live about four times longer than cancer patients not given vitamin C. They administered high-dose vitamin C in the form of sodium ascorbate given orally and intravenously to treat more than 1,000 cancer patients.

Nonetheless, vitamin C for cancer suffered a setback when Dr. Charles Moertel of the Mayo Clinic, an arch foe of nutritional therapies for cancer, sought to disprove Pauling’s thesis. But he did not follow the Pauling/Cameron instructions or regimen.

Moertel selected a cohort of terminal colon cancer patients who had not responded to all forms of conventional treatment, including surgery, chemo and radiation, and administered 10 grams of vitamin C to them orally. When the patients failed to demonstrate improved survival over patients not receiving vitamin C in the study, Moertel pronounced the vitamin C/cancer hypothesis defunct.

Moertel failed to note that the benefits achieved by Pauling and Cameron’s patients were obtained via both IV and oral C. He ultimately succumbed to cancer himself years later.

Alternative practitioners, meanwhile, sought to resurrect IV vitamin C as a tool in the treatment of cancer, but not until recently has serious academic research resumed.

Dr. Hugh Riordan of Kansas treated hundreds of cancer patients with doses of vitamin C up to 200,000 mg (200 grams) per day in infusions lasting 4-12 hours several times a week. He compiled a series of case histories documenting impressive responses but passed recently, before his work was generally acknowledged.

His protegee, Dr. Jeanne Drisko, Director, KU Integrative Medicine, has undertaken a series of clinical trials to validate the benefits of IV vitamin C in cancer. An FDA approved trial is now underway.

Research at the National Institutes of Health is beginning to suggest that vitamin C deserves another chance to find its niche in the arsenal of anti-cancer therapies. Studies now suggest that even high dose vitamin C given by mouth is poorly absorbed. Blood levels “max out” at doses of 500 mg given several times during the day.

But vitamin C given intravenously is another story. When delivered in a “drip,” much higher concentrations of C can be attained. At these higher concentrations, vitamin C has different characteristics than if given orally. While oral vitamin C boosts immunity and assists tissue repair, it is too weak to do much to kill or inhibit cancer cells. But at high doses delivered directly into the bloodstream, it may act to increase levels of hydrogen peroxide deep in the tissues where cancer cells lurk. Peroxide-mediated killing is one of the white blood cells’ key mechanisms for fighting infection and cancer.

Research currently under way has shown that high concentrations of vitamin C can stop the growth or even kill a wide range of cancer cells. Only intravenous administration of vitamin C can deliver the high doses found to be effective against cancer.

IV vitamin C, when administered by a trained, experienced physician, is safe and well-tolerated, even at doses as high as 100,000 mg (100 grams) per day. Proper blood tests must be done to ensure that it is well-tolerated, and the patient must be monitored. Doses must be gradually adjusted upward. Not all patients are candidates for IV vitamin C. Vitamin C can be safely administered even while patients are undergoing chemo and radiation; in fact, the FDA-approved trial at the University of Kansas Medical Center explicitly permits the co-administration of vitamin C with conventional treatments.

3.3 IV Vitamin C Kills Cancer Cells

by Dr. Julian Whitaker

By now, most people know that vitamin C is a potent antioxidant that has the power to boost immune function, increase resistance to infection, and protect against a wide range of diseases.

But there’s an entirely different and largely unknown role of vitamin C, and that is its ability—when administered in very high doses by intravenous (IV) infusions—to kill cancer cells.

Vitamin C interacts with iron and other metals to create hydrogen peroxide. In high concentrations, hydrogen peroxide damages the DNA and mitochondria of cancer cells, shuts down their energy supply, and kills them outright. Best of all—and unlike virtually all conventional chemotherapy drugs that destroy cancer cells—it is selectively toxic. No matter how high the concentration, vitamin C does not harm healthy cells.

Lab studies reveal that this therapy is effective against many types of cancer, including lung, brain, colon, breast, pancreatic, and ovarian. Animal studies show that when human cancers are grafted into animals, high-dose IV vitamin C decreases tumor size by 41 to 53 percent “in diverse cancer types known for both their aggressive growth and limited treatment options.” Additionally, numerous patient case reports have been written up in medical journals.

Why IV Administration Is Essential

The only way to get blood levels of vitamin C to the concentrations required to kill cancer cells is to administer it intravenously. The body tightly controls levels of this vitamin by limiting intestinal absorption. If you took 10 g (10,000 mg) of vitamin C by mouth at one time, you would only absorb around 500 mg—and you’d get a serious case of diarrhea!

Intravenous administration, however, bypasses this control mechanism, and blood levels rise in a dose-dependent manner. For example, 10 g of IV vitamin C raises blood levels 25 times higher than the same dose taken orally, and this increases up to 70-fold as doses get larger.

4 Expert Q&A: Vitamin D and Cancer Risk

http://www.cancer.net/navigating-cancer-care/prevention-and-healthy-living/diet-and-nutrition/expert-qa-vitamin-d-and-cancer-risk

Vitamin D is one of several nutrients that the body needs to stay healthy. It may also play a role in reducing the risk of cancer, and several research studies are exploring this link. Cancer.Net talked with Richard Goldberg, MD, to learn more about current research on vitamin D and what people should know.

Q: What is the role of vitamin D in the body, and what are some sources of this vitamin?

A: One role of vitamin D is to regulate the absorption of calcium by the body. Calcium is the main component of bones and is important in the function of all cells in the body, particularly the heart. People who are vitamin D deficient (don’t get enough) can have weakened bones (a condition called osteoporosis in adults and rickets or osteomalacia in children). Too little calcium (called hypocalcemia) in the body can lead to irregular heartbeat and muscle spasms.

Milk, fish, eggs, and fortified cereals and orange juice are good sources of vitamin D. Milk manufactured in the United States is generally fortified with vitamin D as a way to prevent deficiencies from occurring. Supplemental vitamins are also a source.

Unlike other vitamins that the body cannot produce by itself, vitamin D can either be absorbed directly from the intestine or made from compounds in foods. The body can make vitamin D from nutrients related to cholesterol. These nutrients are then converted to vitamin D as they circulate in the blood when a person’s skin is exposed to sunlight.

Too much vitamin D can also be bad for a person, leading to drowsiness, kidney stones, bone or muscle weakness, and elevated blood calcium, a condition called hypercalcemia that can cause confusion and, in extreme cases, death.

Q: When getting vitamin D from sunlight, how long should a person be exposed to the sun? What are the risks of too much sun exposure?

A: While 90% of the body’s vitamin D comes from exposure to sun (in the absence of vitamin D supplements), the amount of sun exposure needed to produce adequate vitamin D levels is actually quite limited. Sun exposure at the equator is far more intense than in such northern cities as Boston or London, for instance, and is more intense anywhere in summer than in winter. However, it takes only five to ten minutes of exposing the hands and face three times a week to receive adequate sun exposure in the summer in Boston. Exposure of more skin, such as when wearing a bathing suit, requires only a very short time in the sun. Use of sunblock is very important when sun exposure is longer than that to prevent skin cancer, including melanoma, and other sun-induced damage such as wrinkling and pigmentation changes (sunspots). Learn more about protecting your skin from the sun.

Q: How might vitamin D work to help lower the risk of cancer?

A: Laboratory studies have shown that vitamin D deficiency can lead to decreased communication between cells and leads them to stop sticking to one another, a condition that could cause cancer cells to spread. Compared with normal cells, cancer cells remain in an immature state, and vitamin D appears to have a role in making cells mature. Vitamin D also appears to play a role in regulating cellular reproduction, which malfunctions (doesn’t work properly) in cancer. Higher levels of vitamin D lead to cellular adherence, maturation, and communication between cells, all of which may lower cancer risk.

Q: What does research show about vitamin D levels and cancer?

A: Studies in populations have shown that low vitamin D levels are a risk factor for cancer in general, and particularly for prostatecolorectal, and breast cancers.

There are also data that correlate high blood levels of vitamin D with a reduced risk of breast and colorectal cancers. These levels can best be achieved by taking supplemental vitamin D. In colorectal cancer, calcium supplementation may also reduce the risk of polyps (noncancerous growths that may develop on the inner wall of the colon and rectum) and cancer. Numerous studies have tested cancer risk by giving patients supplemental vitamin D, with or without calcium supplementation. While the results are somewhat variable, substantial reduction (on the order of 50%) in the odds of breast and colon cancers with supplementation, have been noted in some studies. People with a personal history of these types of cancer and their relatives may wish to discuss supplementation with their doctors.

5 Magnesium and Cancer Research

5.1  Dr Sircus on Mar 18, 2010
http://drsircus.com/medicine/magnesium/magnesium-and-cancer

Aleksandrowicz et al in Poland conclude that inadequacy of magnesium and antioxidants are important risk factors in predisposing to leukemias.[2] Other researchers found that 46% of the patients admitted to an ICU in a tertiary cancer center presented hypomagnesemia. They concluded that the incidence of hypomagnesemia in critically ill cancer patients is high.[3]In animal studies we find that magnesium deficiency has caused lymphopoietic neoplasms in young rats. A study of rats surviving magnesium deficiency sufficient to cause death in convulsions during early infancy in some, and cardiorenal lesions weeks later in others, disclosed that some of survivors had thymic nodules or lymphosarcoma.[4]

One would not normally think that Magnesium (Mg) deficiency can paradoxically increase the risk of, or protect against cancer yet we will find that just as severe dehydration or asphyxiation can cause death magnesium deficiency can directly lead to cancer. When you consider that over 300 enzymes and ion transport require magnesium and that its role in fatty acid and phospholipids acid metabolism affects permeability and stability of membranes, we can see that magnesium deficiency would lead to physiological decline in cells setting the stage for cancer. Anything that weakens cell physiology will lead to the infections that surround and penetrate tumor tissues. These infections are proving to be an integral part of cancer. Magnesium deficiency poses a direct threat to the health of our cells. Without sufficient amounts our cells calcify and rot. Breeding grounds for yeast and fungi colonies they become, invaders all too ready to strangle our life force and kill us.

Over 300 different enzymes systems rely upon magnesium to facilitate their catalytic action, including ATP metabolism, creatine-kinase activation, adenylate-cyclase, and sodium-potassium-ATPase.[5]

It is known that carcinogenesis induces magnesium distribution disturbances, which cause magnesium mobilization through blood cells and magnesium depletion in non-neoplastic tissues. Magnesium deficiency seems to be carcinogenic, and in case of solid tumors, a high level of supplemented magnesium inhibits carcinogenesis.[6] Both carcinogenesis and magnesium deficiency increase the plasma membrane permeability and fluidity. Scientists have in fact found out that there is much less Mg++ binding to membrane phospholipids of cancer cells, than to normal cell membranes.[7]

Magnesium protects cells from aluminum, mercury, lead, cadmium, beryllium and nickel.

Magnesium in general is essential for the survival of our cells but takes on further importance in the age of toxicity where our bodies are being bombarded on a daily basis with heavy metals.Glutathione requires magnesium for its synthesis.[8] Glutathione synthetase requires ?-glutamyl cysteine, glycine, ATP, and magnesium ions to form glutathione.[9] In magnesium deficiency, the enzyme y-glutamyl transpeptidase is lowered.[10] According to Dr. Russell Blaylock, low magnesium is associated with dramatic increases in free radical generation as well as glutathione depletion and this is vital since glutathione is one of the few antioxidant molecules known to neutralize mercury.[11]Without the cleaning and chelating work of glutathione (magnesium) cells begin to decay as cellular filth and heavy metals accumulates; excellent environments to attract deadly infection/cancer.

There is drastic change in ionic flux from the outer and inner cell membranes both in the impaired membranes of cancer, and in Mg deficiency.

Anghileri et al[12],[13] proposed that modifications of cell membranes are principal triggering factors in cell transformation leading to cancer. Using cells from induced cancers, they found that there is much less magnesium binding to membrane phospholipids of cancer cells, than to normal cell membranes.[14] It has been suggested that Mg deficiency may trigger carcinogenesis by increasing membrane permeability.[15] Magnesium deficient cells membranes seem to have a smoother surface than normal, and decreased membrane viscosity, analogous to changes in human leukemia cells.[16],[17] There is drastic change in ionic flux from the outer and inner cell membranes (higher Ca and Na; lower Mg and K levels), both in the impaired membranes of cancer, and of Mg deficiency. And we find that lead (Pb) salts, are more leukemogenic when given to Mg deficient rats, than when they are given to Mg-adequate rats, suggesting that Mg is protective.[18]

Magnesium has an effect on a variety of cell membranes through a process involving calcium channels and ion transport mechanisms. Magnesium is responsible for the maintenance of the trans-membrane gradients of sodium and potassium.

Long ago researchers postulated that magnesium supplementation of those who are Mg deficient, like chronic alcoholics, might decrease emergence of malignancies[19] and now modern researchers have found that all types of alcohol — wine, beer or liquor — add equally to the risk of developing breast cancer in women. The researchers, led by Dr. Arthur Klatsky of the Kaiser Permanente Medical Care Program in Oakland, Calif., revealed their findings at a meeting of the European Cancer Organization in Barcelona in late 2007. It was found that women who had one or two drinks a day increased their risk of developing breast cancer by 10 percent. Women who had more than three drinks a day raised their risk by 30 percent. The more one drinks the more one drives down magnesium levels.

Breast cancer is the second most common cancer killer of women, after lung cancer. It will be diagnosed in 1.2 million people globally this year and will kill 500,000.

According to data published in the British Journal of Cancer in 2002, 4 percent of all breast cancers — about 44,000 cases a year — in the United Kingdom are due to alcohol consumption. It’s an important question though, and one not asked by medical or health officials, is it the alcohol itself or the resultant drop in magnesium levels that is cancer provoking? Though some studies have shown that light- to moderate alcohol use can protect against heart attacks it does us no good to drink if it causes cancer. Perhaps if magnesium was supplemented in women drinkers who were studied there would have been no increase of cancer from drinking.

Alcohol has always been known to deplete magnesium, and is one of the first supplements given to alcoholics when they stop and attempt to detoxify and withdraw.

Researchers from the School of Public Health at the University of Minnesota have just concluded thatdiets rich in magnesium reduced the occurrence of colon cancer.[20] A previous study from Sweden[21] reported that women with the highest magnesium intake had a 40 per cent lower risk of developing the cancer than those with the lowest intake of the mineral.

Magnesium stabilizes ATP[22], allowing DNA and RNA transcriptions and repairs.[23]

The anti-colon cancer effects of calcium are linked to magnesium levels, says a new study. Researchers from Vanderbilt University found that low ratios of the minerals were associated with reduced risk of colorectal cancer, according to findings presented at the Seventh Annual American Association for Cancer Research International Conference on Frontiers in Cancer Prevention Research. Both high magnesium and calcium levels have been linked to reduced risks of colon cancer but studies have also shown that high calcium levels inhibit the absorption of magnesium. According to Qi Dai, MD, PhD, and co-workers, Americans have high calcium intake, but also a high incidence of colorectal cancer. “If calcium levels were involved alone, you’d expect the opposite direction. There may be something about these two factors combined – the ratio of one to the other – that might be at play,” said Dai. The risk of colorectal cancer adenoma recurrence was reduced by 32 per cent among those with baseline calcium to magnesium ratio below the median in comparison to no reduction for those above the median,” said Dai.[24]

Pre-treatment hypomagnesemia has been reported in young leukemic children, 78% of whom have histories of anorexia, and have excessive gut and urinary losses of Mg.[25]

Several studies have shown an increased cancer rate in regions with low magnesium levels in soil and drinking water, and the same for selenium. In Egypt the cancer rate was only about 10% of that in Europe and America. In the rural fellah it was practically non-existent. The main difference was an extremely high magnesium intake of 2.5 to 3g in these cancer-free populations, ten times more than in most western countries.[26]

5.2 Magnesium and cancer: a dangerous liason.

Castiglioni S, Maier JA.
Magnes Res. 2011 Sep; 24(3):S92-100
http://dx.doi.org:/10.1684/mrh.2011.0285

A complex relationship links magnesium and cancer. The aim of this review is to revisit current knowledge concerning the contribution of magnesium to tumorigenesis, from transformed cells to animal models, and ending with data from human studies. Cultured neoplastic cells tend to accumulate magnesium. High intracellular levels of the cation seem to confer a metabolic advantage to the cells, contribute to alterations of the genome, and promote the acquisition of an immortal phenotype. In magnesium-deficient mice, low magnesium both limits and fosters tumorigenesis, since inhibition of tumor growth at its primary site is observed in the face of increased metastatic colonization. Epidemiological studies identify magnesium deficiency as a risk factor for some types of human cancers. In addition, impaired magnesium homeostasis is reported in cancer patients, and frequently complicates therapy with some anti-cancer drugs. More studies should be undertaken in order to disclose whether a simple and inexpensive intervention to optimize magnesium intake might be helpful in the prevention and treatment of cancer.

Even though cancer-associated death rates are falling steadily, the global burden of cancer continues to increase primarily as a result of an aging population, but also because of the adoption of cancer-causing behaviors, including smoking and a western-type diet [1]. In particular, statistical and epidemiological data point to diet as responsible for about 35% of human cancer mortality [2]. There is general agreement about the inverse correlation between the risk of cancer and the regular consumption of fruit, cereals and vegetables, rich sources of many beneficial micronutrients, vitamins and minerals. Magnesium, which is predominantly obtained by eating unprocessed grains and green leafy vegetables, is an essential micronutrient implicated in a wide variety of regulatory, metabolic and structural activities [3]. The occidental diet is relatively deficient in magnesium Presented in part at the European Magnesium Meeting – EUROMAG Bologna 2011, San Giovanni in Monte, Bologna, Italy, June 8-10, 2011. because of the processing of many food items and the preference for calorie-rich, micronutrient-poor foods [4]. Magnesium deficiency complicates chronic gastrointestinal and renal diseases, diabetes mellitus, alcoholism, and therapies with some classes of diuretics and anticancer drugs [4]. A review of the literature reveals the relationship between magnesium and cancer, from the cellular level through to animal models and humans. Although controversy exists about the role of magnesium in tumors, most of the results available point to low magnesium as a factor contributing to tumorigenesis.

5.1.1 Magnesium acts as a secondary messenger, and activates a vast array of enzymes [3, 5]. Since magnesium participates in all major metabolic processes, as well as redox reactions, it is no surprise that it has a direct role in controlling cell survival and growth. In normal diploid cells, the total concentration of magnesium increases throughout the G1 and S phases of the cell cycle. Accordingly, low extracellular magnesium markedly inhibits their proliferation [3]. Conversely, neoplastic cells are refractory to the proliferative inhibition by low extracellular magnesium but, being extremely avid for the cation, it accumulates in these cells even when cultured in low magnesium levels [6]. This avidity is due, at least in part, to an impairment of Na-dependent magnesium extrusion [7], and to the overexpression of one of the magnesium transporters, namely transient receptor potential melastatin (TRPM)7 [8]. High intracellular magnesium seems to provide a selective advantage for the transformed cells since magnesium contributes to regulating enzymes of various metabolic pathways and of the systems involved in DNA repair. Indeed, magnesium forms complexes with ATP, ADP and GTP, necessary for the activity of enzymes implicated in the transfer of phosphate groups such as glucokinase, phosphofructokinase, phosphoglycerate kinase and pyruvate kinase [9], enzymes of glycolysis known to be the pathway used preferentially by neoplastic cells to produce energy [10]. Magnesium also forms complexes with DNA polymerase, ribonucleases, adenylcyclase, phosphodiesterases,guanylate-cyclase, ATPases and GTPases, being therefore implicated in the metabolism of nucleic acids and proteins, and in signal transduction [9]. Since mutation is a driving force in the development of cancer, it is worth noting that magnesium is involved in the inhibition of N-methylpurine DNA-glycosidase, which initiates base excision repair in DNA by removing a wide variety of alkylated, deaminated, and lipid peroxidation-induced purine adducts [11]. In addition, the nuclear Ser/Thr phosphatase PPM1D (also known as WIP1), which is overexpressed in various human primary tumors, requires magnesium for its activity. PPM1D is involved in the regulation of several essential signaling pathways implicated in tumorigenesis [12, 13]. In particular, PPM1D dephosphorylates and, therefore, inactivates the p53 tumor suppressor gene, a canonical suppressor of proliferation. It also complements several oncogenes, such as Ras, Myc, and HER-2/neu, for cellular transformation both in vitro and in vivo [12].

On these bases, it is possible to conclude that high intracellular magnesium has a role in promoting genetic instability. Another peculiarity of tumor cells is their limitless proliferative potential [14, 15]. It is therefore relevant to point out that magnesium is required to activate telomerase [16-18], a specialized DNA polymerase that extends telomeric DNA and counters the progressive telomere erosion associated with cell duplication. The presence of telomerase activity correlates with a resistance to induction of both senescence and apoptosis which are considered to be crucial anticancer defenses [14, 15]. These points are summarized in figure 1, which also underlines the contribution of high intracellular magnesium to some of the hallmarks of cancer, as highlighted by Hanahan and Weinberg [14, 15]. Mentioning only studies performed on neoplastic cells would be simplistic, since tumors are more than just masses of proliferating cancer cells. Rather, they are complex, heterotypic tissues where normal cells in the stroma, far from being passive bystanders, actively collaborate to cancer development and progression [14, 15]. Many of the growth signals driving the proliferation of and invasion by carcinoma cells originate from the stromal cell components of the tumor mass. It is therefore worth noting that low magnesium modulates the functions of a variety of normal cells present in the tumor microenvironment. In particular, endothelial cells cultured in low magnesium release higher amounts of metalloproteases and growth factors [19]. Similar results were obtained in cultured human fibroblasts (unpublished results). In addition, low magnesium promotes endothelial and fibroblast senescence [20], and senescent cells can modify the tissue environment in a way that synergizes with oncogenic mutations to promote the progression of cancers [21]. Only the behavior of microvascular endothelial cells cultured in low magnesium seems not to fit with the picture described above. It is well known that angiogenesis is crucial to nourish the tumor and facilitate its spreading, but low extracellular magnesium impairs acquisition of the angiogenic phenotype by microvascular endothelial cells. Exposure to low magnesium retards endothelial proliferation, migration and differentiation in vitro ([22] and manuscript submitted). Accordingly, magnesium-deficient mice develop tumors which are significantly less vascularized than the controls [23].

Figure 1. Neoplastic cells tend to have high intracellular concentrations of magnesium, which contribute to the regulation of various metabolic pathways and of systems involved in DNA repair, thus providing a selective advantage for the transformed cells. The figure also links the effects of high intracellular concentrations of magnesium on cell functions to some hallmarks of cancer as highlighted by Hanahan and Weinberg [14, 15].

5.1.2 Low magnesium and cancer: a focus on human studies

Several epidemiological studies have provided evidence that a correlation exists between dietary magnesium and various types of cancer. High levels of magnesium in drinking water protect against oesophageal and liver cancer [36, 37]. In addition, magnesium concentration in drinking water is inversely correlated with death from breast, prostate, and ovarian cancers, whereas no correlation existed for other tumors [36, 38, 39]. Epidemiological studies conducted in various countries demonstrate an association between low intake of magnesium and the risk of colon cancer [40-43]. In addition, a large population-based prospective study in Japan shows a significant inverse correlation between dietary intake of magnesium and colon cancer in men but not in women [44]. Intriguingly, the association between low intake of magnesium and colon cancer is linked to the increased formation of N-nitroso compounds, most of which are potent carcinogens [43]. A further link between magnesium and colon neoplasia is highlighted by the association of adenomatous and hyperplastic polyps, which might progress to carcinoma, with a genetic polymorphism of TRPM7 [45], an ubiquitous ion channel with a central role in magnesium uptake and homeostasis [46]. Results concerning the contribution of magnesium to lung cancer are controversial. A first case-control study correlates low dietary magnesium with increased lung cancer risk both in men and women [47]. This link is more evident in the elderly, current smokers, drinkers and in those with a late-stage disease. To explain the protective effect of magnesium against lung cancer, the authors recall that magnesium regulates cell multiplication, protects against the oxidative stress invariably associated with magnesium deficiency [48], and maintains genomic stability. A recent prospective analysis however, does not support the previous report [49]. These contrasting data could result from recall bias, the difficulty in evaluating diet composition and the fact that smoking is a very strong risk factor for lung cancer.

Conclusion Although the evidence is still fragmentary, most of the data available point to magnesium as a chemopreventive agent, so that optimizing magnesium intake might represent an effective and low-cost preventive measure to reduce cancer risk. Doubts remain about supplementing cancer patients with magnesium. The recently revived interest in the relationship between magnesium and tumors, both in experimental and clinical oncology, should encourage more studies that would advance our understanding of the role of magnesium in tumors, and could explore the possibility that optimizing magnesium homeostasis might prevent cancer or help in its treatment.

5.3 A Magnesium Deficiency Increases Cancer Risk Significantly

Wed, May 21, 2008 by: Mark Sircus

http://www.naturalnews.com/023279_magnesium_cancer_calcium.html#ixzz3ZCT65Fiv

Aleksandrowicz et al in Poland conclude that inadequacy of Mg (Magnesium) and antioxidants are important risk factors in predisposing to leukemias. Other researchers found that 46% of the patients admitted to an ICU (Intensive Care Unit) in a tertiary cancer center presented hypomagnesemia.

They concluded that the incidence of hypomagnesemia in critically ill cancer patients is high. In animal studies we find that Mg deficiency has caused lymphopoietic neoplasms in young rats. A study of rats surviving Mg deficiency sufficient to cause death in convulsions during early infancy in some, and cardiorenal lesions weeks later in others, disclosed that some of survivors had thymic nodules or lymphosarcoma.

One would not normally think that Magnesium (Mg) deficiency can paradoxically increase the risk of, or protect against cancer yet we will find that just as severe dehydration or asphyxiation can cause death, magnesium deficiency can directly lead to cancer. When you consider that over 300 enzymes and ion transport require magnesium and that its role in fatty acid and phospholipid acid metabolism affects permeability and stability of membranes, we can see that magnesiumdeficiency would lead to physiological decline in cells setting the stage for cancer. Anything that weakens cell physiology will lead to the infections that surround and penetrate tumor tissues. These infections are proving to be an integral part of cancer. Magnesium deficiency poses a direct threat to the health of our cells. Without sufficient amounts, our cells calcify and rot in. Breeding grounds for yeast and fungi colonies they become, invaders all too ready to strangle our life force and kill us.

Over 300 different enzymes systems rely upon magnesium to facilitate their catalytic action, including ATP metabolism, creatine-kinase activation, adenylate-cyclase, and sodium-potassium-ATPase.

It is known that carcinogenesis induces magnesium distribution disturbances, which cause magnesium mobilization through blood cells and magnesium depletion in non-neoplastic tissues. Magnesium deficiency seems to be carcinogenic, and in case of solid tumors, a high level of supplemented magnesium inhibits carcinogenesis. Both carcinogenesis and magnesium deficiency increase the plasma membrane permeability and fluidity. Scientists have in fact found out that there is much less Mg++ binding to membrane phospholipids of cancer cells, than to normal cell membranes.

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Making Neurons From Stem Cells: Key Found @UCSF – Pnky, a Noncoding RNA Found in Brain Stem Cells

Reporter: Aviva Lev-Ari, PhD, RN

UCSF Team Finds Key to Making Neurons From Stem Cells

Pnky, a Noncoding RNA Found in Brain Stem Cells, May Have a Broad Range of Clinical Applications

In this cluster of neurons, the greens cells have been infected with a virus to reduce levels of the RNA molecule called Pnky, resulting in increased production of neurons. Someday this finding could be important for regenerative medicine and cancer treatment.

A research team at UC San Francisco has discovered an RNA molecule called Pnky that can be manipulated to increase the production of neurons from neural stem cells.

The research, led by neurosurgeon Daniel A. Lim, MD, PhD, and published on March 19, 2015 in Cell Stem Cell, has possible applications in regenerative medicine, including treatments of such disorders as Alzheimer’s disease, Parkinson’s disease and traumatic brain injury, and in cancer treatment.

Daniel A. Lim, MD, PhD

Co-first authors Alex Ramos, PhD, and Rebecca Andersen, who are students in Lim’s laboratory, first studied Pnky in neural stem cells found in mouse brains, and also identified the molecule in neural stem cells of the developing human brain. They found that when Pnky was removed from stem cells in a process called knockdown, neuron production increased three to four times.

“It is remarkable that when you take Pnky away, the stem cells produce many more neurons,” said Lim, an assistant professor of neurological surgery and director of restorative surgery at UCSF. “These findings suggest that Pnky, and perhaps lncRNAs in general, could eventually have important applications in regenerative medicine and cancer treatment.”

Lim observed that Pnky has an intriguing possible connection with brain tumors.

Pnky is one of a number of newly discovered long noncoding RNAs (lncRNAs), which are stretches of 200 or more nucleotides in the human genome that do not code for proteins, yet seem to have a biological function.

The name, pronounced “Pinky,” was inspired by the popular American cartoon series Pinky and the Brain. “Pnky is encoded near a gene called ‘Brain,’ so it sort of suggested itself to the students in my laboratory,” said Lim. Pnky also appears only to be found in the brain, he noted.

Using an analytical technique called mass spectrometry, Ramos found that Pnky binds the protein PTBP1, which is also found in brain tumors and is known to be a driver of brain tumor growth. In neural stem cells, Pnky and PTBP1 appear to function together to suppress the production of neurons. “Take away one or the other and the stem cells differentiate, making more neurons,” said Lim. “It is also possible that Pnky can regulate brain tumor growth, which means we may have identified a target for the treatment of brain tumors.”

Lim said that the larger significance of the research is that it adds to a growing store of knowledge about lncRNAs, previously unknown sections of the genome that some biologists have referred to as the “dark matter” of the human genome.

“Recently, over fifty thousand human lncRNAs have been discovered. Thus, there may be more human lncRNAs than there are genes that code for proteins,” said Lim. “It is possible that not all lncRNAs have important biological functions, but we are making a start toward learning which ones do, and if so, how they function. It’s a new world of experimental biology, and the students in my lab are right there on the frontier.”

Lim had particular praise for Ramos, an MD-PhD student in the UCSF Medical Scientist Training Program, and Andersen, who has a fellowship from the prestigious National Science Foundation (NSF) Graduate Research Fellowship Program. “They have been a great collaborative team and an inspiration to others in my lab,” said Lim. “I think they represent the pioneering, investigative spirit of the UCSF student body.”

Co-authors of the study are Siyuan John Liu, Tomasz Jan Nowakowski, Sung Jun Hong, Caitlin Gertz, Ryan D. Salinas, Hosniya Zarabi and Arnold Kriegstein, MD, PhD, all of UCSF.

Students’ Willingness to Experiment Played Key Role in Discovery

Seven of the 10 authors were pre-doctoral graduate students when they made their discoveries.

Alex Ramos, PhD

Co-first author Alex Ramos, PhD, who completed his thesis in Lim’s lab, said being a student lends distinct advantages for making discoveries.

“When I started a few years ago, nobody had a good understanding of how lncRNAs worked, or even if they had any function at all outside of the cell culture dish,” said Ramos, who is now working toward his MD.

“I think that as a graduate student, I felt free to take the plunge into an extremely new, and in many ways, risky, field.”

Co-first author Becky Andersen agreed:  “This was a completely new field for me, and that allowed me to look at everything from a different perspective than someone who had been immersed in the neural stem cell field for years.”

Becky Andersen, PhD candidate

“Alex and Becky both understand the spirit of experimental biology,” said Lim. “When you’re working in an area that’s poorly understood, you have to be willing to let your own data drive the direction of your research, which often takes you to new and unexpected places. That’s what makes these two students very special.”

Team collaboration also played a key role in the research.  Ramos said co-author John Liu helped teach him new computational methods that “allowed me to leave my comfort zone and analyze data in new ways I wouldn’t have thought of.”

“The collaborative environment fostered by UCSF has not only aided my scientific pursuits, but has also made graduate school an immensely rewarding experience,” concludes Andersen.

The study was supported by funds from the National Institutes of Health, U.S. Department of Veterans Affairs, NSF, UCSF, San Francisco State University and the Howard Hughes Medical Institute.

UCSF is the nation’s leading university exclusively focused on health. Now celebrating the 150th anniversary of its founding as a medical college, UCSF is dedicated to transforming health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with world-renowned programs in the biological sciences, a preeminent biomedical research enterprise and two top-tier hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospital San Francisco.

SOURCE

http://www.ucsf.edu/news/2015/03/123906/ucsf-team-finds-key-making-neurons-stem-cells?elq=772354036ecc46c48e2eddfa2a6cc957&elqCampaignId=17&elqaid=12351&elqat=1&elqTrackId=3163ddffc41f41f399c73e12fea8ff7e

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Voluntary and Involuntary S- Insufficiency

Writer and Curator: Larry H Bernstein, MD, FCAP 

Transthyretin and the Stressful Condition

Introduction

This article is written among a series of articles concerned with stress, obesity, diet and exercise, as well as altitude and deep water diving for extended periods, and their effects.  There is a reason that I focus on transthyretin (TTR), although much can be said about micronutients and vitamins, and fat soluble vitamins in particular, and iron intake during pregnancy.    While the importance of vitamins and iron are well accepted, the metabolic basis for their activities is not fully understood.  In the case of a single amino acid, methionine, it is hugely important because of the role it plays in sulfur metabolism, the sulfhydryl group being essential for coenzyme A, cytochrome c, and for disulfide bonds.  The distribution of sulfur, like the distribution of iodine, is not uniform across geographic regions.  In addition, the content of sulfur found in plant sources is not comparable to that in animal protein.  There have been previous articles at this site on TTR, amyloid and sepsis.

Transthyretin and Lean Body Mass in Stable and Stressed State

http://pharmaceuticalintelligence.com/2013/12/01/transthyretin-and-lean-body-mass-in-stable-and-stressed-state/

A Second Look at the Transthyretin Nutrition Inflammatory Conundrum

http://pharmaceuticalintelligence.com/2012/12/03/a-second-look-at-the-transthyretin-nutrition-inflammatory-conundrum/

Stabilizers that prevent transthyretin-mediated cardiomyocyte amyloidotic toxicity

http://pharmaceuticalintelligence.com/2013/12/02/stabilizers-that-prevent-transthyretin-mediated-cardiomyocyte-amyloidotic-toxicity/

Thyroid Function and Disorders

http://pharmaceuticalintelligence.com/2015/02/05/thyroid-function-and-disorders/

Proteomics, Metabolomics, Signaling Pathways, and Cell Regulation: a Compilation of Articles in the Journal http://pharmaceuticalintelligence.com

http://pharmaceuticalintelligence.com/2014/09/01/compilation-of-references-in-leaders-in-pharmaceutical-intelligence-about-proteomics-metabolomics-signaling-pathways-and-cell-regulation-2/

Malnutrition in India, high newborn death rate and stunting of children age under five years

http://pharmaceuticalintelligence.com/2014/07/15/malnutrition-in-india-high-newborn-death-rate-and-stunting-of-children-age-under-five-years/

Vegan Diet is Sulfur Deficient and Heart Unhealthy

http://pharmaceuticalintelligence.com/2013/11/17/vegan-diet-is-sulfur-deficient-and-heart-unhealthy/

How Methionine Imbalance with Sulfur-Insufficiency Leads to Hyperhomocysteinemia

http://pharmaceuticalintelligence.com/2013/04/04/sulfur-deficiency-leads_to_hyperhomocysteinemia/

Amyloidosis with Cardiomyopathy

http://pharmaceuticalintelligence.com/2013/03/31/amyloidosis-with-cardiomyopathy/

Advances in Separations Technology for the “OMICs” and Clarification of Therapeutic Targets

http://pharmaceuticalintelligence.com/2012/10/22/advances-in-separations-technology-for-the-omics-and-clarification-of-therapeutic-targets/

Sepsis, Multi-organ Dysfunction Syndrome, and Septic Shock: A Conundrum of Signaling Pathways Cascading Out of Control

http://pharmaceuticalintelligence.com/2012/10/13/sepsis-multi-organ-dysfunction-syndrome-and-septic-shock-a-conundrum-of-signaling-pathways-cascading-out-of-control/

Automated Inferential Diagnosis of SIRS, sepsis, septic shock

http://pharmaceuticalintelligence.com/2012/08/01/automated-inferential-diagnosis-of-sirs-sepsis-septic-shock/

Transthyretin and the Systemic Inflammatory Response 

Transthyretin has been widely used as a biomarker for identifying protein-energy malnutrition (PEM) and for monitoring the improvement of nutritional status after implementing a nutritional intervention by enteral feeding or by parenteral infusion. This has occurred because transthyretin (TTR) has a rapid removal from the circulation in 48 hours and it is readily measured by immunometric assay. Nevertheless, concerns have been raised about the use of TTR in the ICU setting, which prompts a review of the actual benefit of using this test in a number of settings. TTR is easily followed in the underweight and the high risk populations in an ambulatory setting, which has a significant background risk of chronic diseases.  It is sensitive to the systemic inflammatory response syndrom (SIRS), and needs to be understood in the context of acute illness to be used effectively. There are a number of physiologic changes associated with SIRS and the injury/repair process that will affect TTR and will be put in context in this review. The most important point is that in the context of an ICU setting, the contribution of TTR is significant in a complex milieu.  copyright @ Bentham Publishers Ltd. 2009.

Transthyretin as a marker to predict outcome in critically ill patients.
Arun Devakonda, Liziamma George, Suhail Raoof, Adebayo Esan, Anthony Saleh, Larry H. Bernstein.
Clin Biochem Oct 2008; 41(14-15): 1126-1130

A determination of TTR level is an objective method od measuring protein catabolic loss of severly ill patients and numerous studies show that TTR levels correlate with patient outcomes of non-critically ill patients. We evaluated whether TTR level correlates with the prevalence of PEM in the ICUand evaluated serum TTR level as an indicator of the effectiveness of nutrition support and the prognosis in critically ill patients.

TTR showed excellent concordance with patients classified with PEM or at high malnutrition risk, and followed for 7 days, it is a measure of the metabolic burden. TTR levels did not respond early to nutrition support because of the delayed return to anabolic status. It is particularly helpful in removing interpretation bias, and it is an excellent measure of the systemic inflammatory response concurrent with a preexisting state of chronic inanition.

 The Stressful Condition as a Nutritionally Dependent Adaptive Dichotomy

Yves Ingenbleek and Larry Bernstein
Nutrition 1999;15(4):305-320 PII S0899-9007(99)00009-X

The injured body manifests a cascade of cytokine-induced metabolic events aimed at developing defense mechanisms and tissue repair. Rising concentrations of counterregulatory hormones work in concert with cytokines to generate overall insulin and insulin-like growth factor 1 (IGF-1), postreceptor resistance and energy requirements grounded on lipid dependency. Dalient features are self-sustained hypercortisolemia persisting as long as cytokines are oversecreted and down-regulation of the hypothalamo-pituitary-thyroid axis stabilized at low basal levels. Inhibition of thyroxine 5’deiodinating activity (5’DA) accounts for the depressed T3 values associated with the sparing of both N and energy-consuming processes. Both the liver and damaged territories adapt to stressful signals along up-regulated pathways disconnected from the central and peripheral control systems. Cytokines stimulate 5’DA and suppress the synthesis of TTR, causing the drop of retinol-binding protein (RBP) and the leakage of increased amounts of T4 and retinol in free form. TTR and RBP thus work as prohormonal reservoirs of precursor molecules which need to be converted into bioactive derivatives (T3 and retinoic acids) to reach transcriptional efficiency. The converting steps (5’DA and cellular retinol-binding protein-1) are activated to T4 and retinol, themselves operating as limiting factors to positive feedback loops. …The suicidal behavior of TBG, CBG, and IGFBP-3 allows the occurrence of peak endocrine and mitogenic influences at the site of inflammation. The production rate of TTR by the liver is the main determinant of both the hepatic release and blood transport of holoRBP, which explains why poor nutritional status concomitantly impairs thyroid- and retinoid-dependent acute phase responses, hindering the stressed body to appropriately face the survival crisis.  …
abbreviations: TBG, thyroxine-binding globulain; CBG, cortisol-binding globulin; IGFBP-3, insulin growth factor binding protein-3; TTR, transthyretin; RBP, retionol-binding protein.

Why Should Plasma Transthyretin Become a Routine Screening Tool in Elderly Persons? 

Yves Ingenbleek.
J Nutrition, Health & Aging 2009.

The homotetrameric TTR molecule (55 kDa as MM) was first identified in cerebrospinal fluid (CSF).  The initial name of prealbumin (PA)  was assigned based on the electrophoretic migration anodal to albumin. PA was soon recognized as a specific binding protein for thyroid hormone. and also of plasma retinol through the mediation of the small retinol-binding protein (RBP, 21 kDa as MM), which has a circulating half-life half that of TTR (24 h vs 48 h).

There exist at least 3 goos reasons why TTR should become a routine medical screening test in elderly persons.  The first id grounded on the assessment of protein nutritional status that is frequently compromized and may become a life threatening condition.  TTR was proposed as a marker of protein-energy malnutrition (PEM) in 1972. As a result of protein and energy deprivation, TTR hepatic synthesis is suppressed whereas all plasma indispensable amino acids (IAAs) manifest declining trends with the sole exception of methionine (Met) whose concentration usually remains unmodified. By comparison with ALB and transferrin (TF) plasma values, TTR did reveal a much higher degree of reactivity to changes in protein status that has been attributed to its shorter biological half-life and to its unusual tryptophan richness. The predictive ability of outcome offered by TTR is independent of that provided by ALB and TF. Uncomplicated PEM primarily affects the size of body nitrogen (N) pools, allowing reduced protein syntheses to levels compatible with survival.  These adaptiver changes are faithfully identified by the serial measurement of TTR whose reliability has never been disputed in protein-depleted states. On the contrary, the nutritional relevance of TTR has been controverted in acute and chronic inflammatory conditions due to the cytokine-induced transcriptional blockade of liver synthesis which is an obligatory step occurring independently from the prevailing nutritional status. Although PEM and stress ful disorders refer to distinct pathogenic mechanisms, their combined inhibitory effects on TTR liber production fueled a long-lasting strife regarding a poor specificity.  Recent body compositional studies have contributed to disentagling these intermingled morbidities, showing that evolutionary patterns displayed by plasma TTR are closely correlated with the fluctuations of lean body mass (LBM).

The second reason follows from advances describing the unexpected relationship established between TTR and homocysteine (Hcy), a S-containing AA not found in customary diets but resulting from the endogenous transmethylation of dietary methionine.  Hcy may be recycled to Met along a remethylation pathway (RM) or irreversibly degraded throughout the transsulfuration (TS) cascade to relase sulfaturia as end-product. Hcy is thus situated at the crossrad of RM and TS pathways which are in equilibrium keeping plasma Met values unaltered.  Three dietary water soluble B viatamins are implicated in the regulation of the Hcy-Met cycle. Folates (vit B9) are the most powerful agent, working as a supplier of the methyl group required for the RM process whereas cobalamines (vit B12) and pyridoxine (vit B6) operate as cofactors of Met-synthase and cystathionine-β-synthase.  Met synthase promotes the RM pathway whereas the rate-limiting CβS governs the TS degradative cascade. Dietary deficiency in any of the 3 vitamins may upregulate Hcy plasma values, an acquied biochemiucal anomaly increasingly encountered in aged populations.

The third reason refers to recent and fascinating data recorded in neurobiology and emphasizing the specific properties of TTR in the prevention of brain deterioration. TTR participates directly in the maintenance of memory and normal cognitive processes during the aging process by acting on the retinoid signaling pathway.  Moreover, TTR may bind amyloid β peptide in vitro, preventing its transformation into toxic amyloid fibrils and amyloid plaques.  TTR works as a limiting factor for the plasma transport of retinoid, which in turn operates as a limiting determinant of both physiologically active retinoic acid (RA) derivatives, implying that any fluctuation in protein status might well entail corresponding  alterations in cellular bioavailability of retinoid compounds.  Under normal aging circumstances, the concentration of retinoid compounds declines in cerebral tissues together with the downregulation of RA receptor expression. In animal models, depletion of RAs causes the deposition of amyloid-β peptides, favoring the formation of amyloid plaques.

Prealbumin and Nutritional Evaluation

Larry Bernstein, Walter Pleban
Nutrition Apr 1996; 12(4):255-259.
http://nutritionjrnl.com/article/S0899-9007(96)90852-7

We compressed 16-test-pattern classes of albumin (ALB), cholesterol (CHOL), and total protein (TPR) in 545 chemistry profiles to 4 classes by conveerting decision values to a number code to separate malnourished (1 or 2) from nonmalnourished (NM)(0) patients using as cutoff values for NM (0), mild (1), and moderate (2): ALB 35, 27 g/L; TPR 63, 53 g/L; CHOL 3.9, 2.8 mmol/L; and BUN 9.3, 3.6 mmol/L. The BUN was found to have  to have too low an S-value to make a contribution to the compressed classification. The cutoff values for classifying the data were assigned prior to statistical analysis, after examining information in the structured data. The data was obtained by a natural experiment in which the test profiles routinely done by the laboratory were randomly extracted. The analysis identifies the values used that best classify the data and are not dependent on distributional assumptions. The data were converted to 0, 1, or 2 as outcomes, to create a ternary truth table (eaxch row in nnn, the n value is 0 to 2). This allows for 3(81) possible patterns, without the inclusion of prealbumin (TTR). The emerging system has much fewer patterns in the information-rich truth table formed (a purposeful, far from random event). We added TTR, coded, and examined the data from 129 patients. The classes are a compressed truth table of n-coded patterns with outcomes of 0, 1, or 2 with protein-energy malnutrition (PEM) increasing from an all-0 to all-2 pattern.  Pattern class (F=154), PAB (F=35), ALB (F=56), and CHOL (F=18) were different across PEM class and predicted PEM class (R-sq. = 0.7864, F=119, p < E-5). Kruskall-Wallis analysis of class by ranks was significant for pattern class E-18), TTR (6.1E-15) ALB (E-16), CHOL (9E-10), and TPR (5E-13). The medians and standard error (SEM) for TTR, ALB, and CHOL of four TTR classes (NM, mild, mod, severe) are: TTR = 209, 8.7; 159, 9.3; 137, 10.4; 72, 11.1 mg/L. ALB – 36, 0.7; 30.5, 0.8; 25.0, 0.8; 24.5, 0.8 g/L. CHOL = 4.43, 0.17; 4.04, 0.20; 3.11, 0.21; 2.54, 0.22 mmol/L. TTR and CHOL values show the effect of nutrition support on TTR and CHOL in PEM. Moderately malnourished patients receiving nutrition support have TTR values in the normal range at 137 mg/L and at 159 mg/L when the ALB is at 25 g/L or at 30.5 g/L.

An Informational Approach to Likelihood of Malnutrition 

Larry Bernstein, Thomas Shaw-Stiffel, Lisa Zarney, Walter Pleban.
Nutrition Nov 1996;12(11):772-776.  PII: S0899-9007(96)00222-5.
http://dx.doi.org:/nutritionjrnl.com/article/S0899-9007(96)00222-5

Unidentified protein-energy malnutrition (PEM) is associated with comorbidities and increased hospital length of stay. We developed a model for identifying severe metabolic stress and likelihood of malnutrition using test patterns of albumin (ALB), cholesterol (CHOL), and total protein (TP) in 545 chemistry profiles…They were compressed to four pattern classes. ALB (F=170), CHOL (F = 21), and TP (F = 5.6) predicted PEM class (R-SQ = 0.806, F= 214; p < E^-6), but pattern class was the best predictor (R-SQ = 0.900, F= 1200, p< E^-10). Ktuskal-Wallis analysis of class by ranks was significant for pattern class (E^18), ALB (E^-18), CHOL (E^-14), TP (@E^-16). The means and SEM for tests in the three PEM classes (mild, mod, severe) were; ALB – 35.7, 0.8; 30.9, 0.5; 24.2, 0.5 g/L. CHOL – 3.93, 0.26; 3.98, 0.16; 3.03, 0.18 µmol/L, and TP – 68.8, 1.7; 60.0, 1.0; 50.6, 1.1 g/L. We classified patients at risk of malnutrition using truth table comprehension.

Downsizing of Lean Body Mass is a Key Determinant of Alzheimer’s Disease

Yves Ingenbleek, Larry Bernstein
J Alzheimer’s Dis 2015; 44: 745-754.
http://dx.doi.org:/10.3233/JAD-141950

Lean body mass (LBM) encompasses all metabolically active organs distributed into visceral and structural tissue compartments and collecting the bulk of N and K stores of the human body. Transthyretin (TTR)  is a plasma protein mainly secreted by the liver within a trimolecular TTR-RBP-retinol complex revealing from birth to old age strikingly similar evolutionary patterns with LBM in health and disease. TTR is also synthesized by the choroid plexus along distinct regulatory pathways. Chronic dietary methionine (Met) deprivation or cytokine-induced inflammatory disorders generates LBM downsizing following differentiated physiopathological processes. Met-restricted regimens downregulate the transsulfuration cascade causing upstream elevation of homocysteine (Hcy) safeguarding Met homeostasis and downstream drop of hydrogen sulfide (H2S) impairing anti-oxidative capacities. Elderly persons constitute a vulnerable population group exposed to increasing Hcy burden and declining H2S protection, notably in plant-eating communities or in the course of inflammatory illnesses. Appropriate correction of defective protein status and eradication of inflammatory processes may restore an appropriate LBM size allowing the hepatic production of the retinol circulating complex to resume, in contrast with the refractory choroidal TTR secretory process. As a result of improved health status, augmented concentrations of plasma-derived TTR and retinol may reach the cerebrospinal fluid and dismantle senile amyloid plaques, contributing to the prevention or the delay of the onset of neurodegenerative events in elderly subjects at risk of Alzheimer’s disease.

Amyloidogenic and non-amyloidogenic transthyretin variants interact differently with human cardiomyocytes: insights into early events of non-fibrillar tissue damage

Pallavi Manral and Natalia Reixach
Biosci.Rep.(2015)/35/art:e00172 http://dx.doi.org:/10.1042/BSR20140155

TTR (transthyretin) amyloidosis are diseases characterized by the aggregation and extracellular deposition of the normally soluble plasma protein TTR. Ex vivo and tissue culture studies suggest that tissue damage precedes TTR fibril deposition, indicating that early events in the amyloidogenic cascade have an impact on disease development. We used a human cardiomyocyte tissue culture model system to define these events. We previously described that the amyloidogenic V122I TTR variant is cytotoxic to human cardiac cells, whereas the naturally occurring, stable and non-amyloidogenic T119M TTR variant is not. We show that most of the V122I TTR interacting with the cells is extracellular and this interaction is mediated by a membraneprotein(s). In contrast, most of the non-amyloidogenic T119M TTR associated with the cells is intracellular where it undergoes lysosomal degradation. The TTR internalization process is highly dependent on membrane cholesterol content. Using a fluorescent labelled V122I TTR variant that has the same aggregation and cytotoxic potential as the native V122I TTR, we determined that its association with human cardiomyocytes is saturable with a KD near 650nM. Only amyloidogenic V122I TTR compete with fluorescent V122I force ll-binding sites. Finally, incubation of the human cardiomyocytes with V122I TTR but not with T119M TTR, generates superoxide species and activates caspase3/7. In summary, our results show that the interaction of the amyloidogenic V122I TTR is distinct from that of a non-amyloidogenic TTR variant and is characterized by its retention at the cell membrane, where it initiates the cytotoxic cascade.

Emerging roles for retinoids in regeneration and differentiation in normal and disease states

Lorraine J. Gudas
Biochimica et Biophysica Acta 1821 (2012) 213–221
http://dx.doi.org:/10.1016/j.bbalip.2011.08.002

The vitamin (retinol) metabolite, all-transretinoic acid (RA), is a signaling molecule that plays key roles in the development of the body plan and induces the differentiation of many types of cells. In this review the physiological and pathophysiological roles of retinoids (retinol and related metabolites) in mature animals are discussed. Both in the developing embryo and in the adult, RA signaling via combinatorial Hoxgene expression is important for cell positional memory. The genes that require RA for the maturation/differentiation of T cells are only beginning to be cataloged, but it is clear that retinoids play a major role in expression of key genes in the immune system. An exciting, recent publication in regeneration research shows that ALDH1a2(RALDH2), which is the rate-limiting enzyme in the production of RA from retinaldehyde, is highly induced shortly after amputation in the regenerating heart, adult fin, and larval fin in zebrafish. Thus, local generation of RA presumably plays a key role in fin formation during both embryogenesis and in fin regeneration. HIV transgenic mice and human patients with HIV-associated kidney disease exhibit a profound reduction in the level of RARβ protein in the glomeruli, and HIV transgenic mice show reduced retinol dehydrogenase levels, concomitant with a greater than 3-fold reduction in endogenous RA levels in the glomeruli. Levels of endogenous retinoids (those synthesized from retinol within cells) are altered in many different diseases in the lung, kidney, and central nervous system, contributing to pathophysiology.

The Membrane Receptor for Plasma Retinol-Binding Protein, A New Type of Cell-Surface Receptor

Hui Sun and Riki Kawaguchi
Intl Review Cell and Molec Biol, 2011; 288:Chap 1. Pp 1:34
http://dx.doi.org:/10.1016/B978-0-12-386041-5.00001-7

Vitamin A is essential for diverse aspects of life ranging from embryogenesis to the proper functioning of most adul torgans. Its derivatives (retinoids) have potent biological activities such as regulating cell growth and differentiation. Plasma retinol-binding protein (RBP) is the specific vitamin A carrier protein in the blood that binds to vitamin A with high affinity and delivers it to target organs. A large amount of evidence has accumulated over the past decades supporting the existence of a cell-surface receptor for RBP that mediates cellular vitamin A uptake. Using an unbiased strategy, this specific cell-surface RBP receptor has been identified as STRA6, a multi-transmembrane domain protein with previously unknown function. STRA6 is not homologous to any protein of known function and represents a new type of cell-surface receptor. Consistent with the diverse functions of vitamin A, STRA6 is widely expressed in embryonic development and in adult organ systems. Mutations in human STRA6 are associated with severe pathological phenotypes in many organs
such as the eye, brain, heart, and lung. STRA6 binds to RBP with high affinity and mediates vitamin A uptake into cells. This review summarizes the history of the RBP receptor research, its expression in the context of known functions of vitamin A in distinct human organs, structure/function analysis of this new type of membrane receptor, pertinent questions regarding its very existence, and its potential implication in treating human diseases.

Choroid plexus dysfunction impairs beta-amyloid clearance in a triple transgenic mouse model of Alzheimer’s disease

Ibrahim González-Marrero, Lydia Giménez-Llort, Conrad E. Johanson, et al.
Front Cell Neurosc  Feb2015; 9(17): 1-10
http://dx.doi.org:/10.3389/fncel.2015.00017

Compromised secretory function of choroid plexus (CP) and defective cerebrospinal fluid (CSF) production, along with accumulation of beta-amyloid (Aβ) peptides at the blood-CSF barrier (BCSFB), contribute to complications of Alzheimer’s disease (AD). The AD triple transgenic mouse model (3xTg-AD) at 16 month-old mimics critical hallmarks of the human disease: β-amyloid (Aβ) plaques and neurofibrillary tangles (NFT) with a temporal-and regional-specific profile. Currently, little is known about transport and metabolic responses by CP to the disrupted homeostasis of CNS Aβ in AD. This study analyzed the effects of highly-expressed AD-linked human transgenes (APP, PS1 and tau) on lateral ventricle CP function. Confocal imaging and immunohistochemistry revealed an increase only of Aβ42 isoform in epithelial cytosol and in stroma surrounding choroidal capillaries; this buildup may reflect insufficient clearance transport from CSF to blood. Still, there was increased expression, presumably compensatory, of the choroidal Aβ transporters: the low density lipoprotein receptor-related protein1 (LRP1) and the receptor for advanced glycation end product (RAGE). A thickening of the epithelial basal membrane and greater collagen-IV deposition occurred around capillaries in CP, probably curtailing solute exchanges. Moreover, there was attenuated expression of epithelial aquaporin-1 and transthyretin(TTR) protein compared to Non-Tg mice. Collectively these findings indicate CP dysfunction hypothetically linked to increasing Aβ burden resulting in less efficient ion transport, concurrently with reduced production of CSF (less sink action on brain Aβ) and diminished secretion of TTR (less neuroprotection against cortical Aβ toxicity). The putative effects of a disabled CP-CSF system on CNS functions are discussed in the context of AD.

Endoplasmic reticulum: The unfolded protein response is tangled In neurodegeneration

Jeroen J.M. Hoozemans, Wiep Scheper
Intl J Biochem & Cell Biology 44 (2012) 1295–1298
http://dx.doi.org/10.1016/j.biocel.2012.04.023

Organelle facts•The ER is involved in the folding and maturation ofmembrane-bound and secreted proteins.•The ER exerts protein quality control to ensure correct folding and to detect and remove misfolded proteins.•Disturbance of ER homeostasis leads to protein misfolding and induces the UPR.•Activation of the UPR is aimed to restore proteostasis via an intricate transcriptional and (post)translational signaling network.•In neurodegenerative diseases classified as tauopathies the activation of the UPR coincides with the pathogenic accumulation of the microtubule associated protein tau.•The involvement of the UPR in tauopathies makes it a potential therapeutic target.

The endoplasmic reticulum (ER) is involved in the folding and maturation of membrane-bound and secreted proteins. Disturbed homeostasis in the ER can lead to accumulation of misfolded proteins, which trigger a stress response called the unfolded protein response (UPR). In neurodegenerative diseases that are classified as tauopathies, activation of the UPR coincides with the pathogenic accumulation of the microtubule associated protein tau. Several lines of evidence indicate that UPR activation contributes to increased levels of phosphorylated tau, a prerequisite for the formation of tau aggregates. Increased understanding of the crosstalk between signaling pathways involved in protein quality control in the ERand tau phosphorylation will support the development of new therapeutic targets that promote neuronal survival.

Chemical and/or biological therapeutic strategies to ameliorate protein misfolding diseases

Derrick Sek Tong Ong and Jeffery W Kelly
Current Opin Cell Biol 2011; 23:231–238
http://dx.doi.org:/10.1016/j.ceb.2010.11.002

Inheriting a mutant misfolding-prone protein that cannot be efficiently folded in a given cell type(s) results in a spectrum of human loss-of-function misfolding diseases. The inability of the biological protein maturation pathways to adapt to a specific misfolding-prone protein also contributes to pathology. Chemical and biological therapeutic strategies are presented that restore protein homeostasis, or proteostasis, either by enhancing the biological capacity of the proteostasis network or through small molecule stabilization of a specific misfolding-prone protein. Herein, we review the recent literature on therapeutic strategies to ameliorate protein misfolding diseases that function through either of these mechanisms, or a combination thereof, and provide our perspective on the promise of alleviating protein misfolding diseases by taking advantage of proteostasis adaptation.

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The Vibrant Philly Biotech Scene: Focus on KannaLife Sciences and the Discipline and Potential of Pharmacognosy

Curator and Interviewer: Stephen J. Williams, Ph.D.

Article ID #167: The Vibrant Philly Biotech Scene: Focus on KannaLife Sciences and the Discipline and Potential of Pharmacognosy. Published on 2/19/2015

WordCloud Image Produced by Adam Tubman

 

philly2nightThis post is the third in a series of posts highlighting interviews with Philadelphia area biotech startup CEO’s and show how a vibrant biotech startup scene is evolving in the city as well as the Delaware Valley area. Philadelphia has been home to some of the nation’s oldest biotechs including Cephalon, Centocor, hundreds of spinouts from a multitude of universities as well as home of the first cloned animal (a frog), the first transgenic mouse, and Nobel laureates in the field of molecular biology and genetics. Although some recent disheartening news about the fall in rankings of Philadelphia as a biotech hub and recent remarks by CEO’s of former area companies has dominated the news, biotech incubators like the University City Science Center and Bucks County Biotechnology Center as well as a reinvigorated investment community (like PCCI and MABA) are bringing Philadelphia back. And although much work is needed to bring the Philadelphia area back to its former glory days (including political will at the state level) there are many bright spots such as the innovative young companies as outlined in these posts.

In today’s post, I had the opportunity to talk with both Dr. William Kinney, Chief Scientific Officer and Thoma Kikis, Founder/CMO of KannaLife Sciences based in the Pennsylvania Biotech Center of Bucks County.   KannaLifeSciences, although highlighted in national media reports and Headline news (HLN TV)for their work on cannabis-derived compounds, is a phyto-medical company focused on the discipline surrounding pharmacognosy, the branch of pharmacology dealing with natural drugs and their constituents.

Below is the interview with Dr. Kinney and Mr. Kikis of KannaLife Sciences and Leaders in Pharmaceutical Business Intelligence (LPBI)

 

PA Biotech Questions answered by Dr. William Kinney, Chief Scientific Officer of KannaLife Sciences

 

 

LPBI: Your parent company   is based in New York. Why did you choose the Bucks County Pennsylvania Biotechnology Center?

 

Dr. Kinney: The Bucks County Pennsylvania Biotechnology Center has several aspects that were attractive to us.  They have a rich talent pool of pharmaceutically trained medicinal chemists, an NIH trained CNS pharmacologist,  a scientific focus on liver disease, and a premier natural product collection.

 

LBPI: The Blumberg Institute and Natural Products Discovery Institute has acquired a massive phytochemical library. How does this resource benefit the present and future plans for KannaLife?

 

Dr. Kinney: KannaLife is actively mining this collection for new sources of neuroprotective agents and is in the process of characterizing the active components of a specific biologically active plant extract.  Jason Clement of the NPDI has taken a lead on these scientific studies and is on our Advisory Board. 

 

LPBI: Was the state of Pennsylvania and local industry groups support KannaLife’s move into the Doylestown incubator?

 

Dr. Kinney: The move was not State influenced by state or industry groups. 

 

LPBI: Has the partnership with Ben Franklin Partners and the Center provided you with investment opportunities?

 

Dr. Kinney: Ben Franklin Partners has not yet been consulted as a source of capital.

 

LPBI: The discipline of pharmacognosy, although over a century old, has relied on individual investigators and mainly academic laboratories to make initial discoveries on medicinal uses of natural products. Although there have been many great successes (taxol, many antibiotics, glycosides, etc.) many big pharmaceutical companies have abandoned this strategy considering it a slow, innefective process. Given the access you have to the chemical library there at Buck County Technology Center, the potential you had identified with cannabanoids in diseases related to oxidative stress, how can KannaLife enhance the efficiency of finding therapeutic and potential preventive uses for natural products?

 

Dr. Kinney: KannaLife has the opportunity to improve upon natural molecules that have shown medically uses, but have limitations related to safety and bioavailability. By applying industry standard medicinal chemistry optimization and assay methods, progress is being made in improving upon nature.  In addition KannaLife has access to one of the most commercially successful natural products scientists and collections in the industry.

 

LPBI: How does the clinical & regulatory experience in the Philadelphia area help a company like Kannalife?

 

Dr. Kinney: Within the region, KannaLife has access to professionals in all areas of drug development either by hiring displaced professionals or partnering with regional contract research organizations.

 

LPBI  You are focusing on an interesting mechanism of action (oxidative stress) and find your direction appealing (find compounds to reverse this, determine relevant disease states {like HCE} then screen these compounds in those disease models {in hippocampal slices}).  As oxidative stress is related to many diseases are you trying to develop your natural products as preventative strategies, even though those type of clinical trials usually require massive numbers of trial participants or are you looking to partner with a larger company to do this?

 

Dr. Kinney: Our strategy is to initially pursue Hepatic Encephalophy (HE) as the lead orphan disease indication and then partner with other organizations to broaden into other areas that would benefit from a neuroprotective agent.  It is expected the HE will be responsive to an acute treatment regimen.   We are pursuing both natural products and new chemical entities for this development path.

 

 

General Questions answered by Thoma Kikis, Founder/CMO of KannaLife Sciences

 

LPBI: How did KannaLife get the patent from the National Institutes of Health?

 

My name is Thoma Kikis I’m the co-founder of KannaLife Sciences. In 2010, my partner Dean Petkanas and I founded KannaLife and we set course applying for the exclusive license of the ‘507 patent held by the US Government Health and Human Services and National Institutes of Health (NIH). We spent close to 2 years working on acquiring an exclusive license from NIH to commercially develop Patent 6,630,507 “Cannabinoids as Antioxidants and Neuroprotectants.” In 2012, we were granted exclusivity from NIH to develop a treatment for a disease called Hepatic Encephalopathy (HE), a brain liver disease that stems from cirrhosis.

 

Cannabinoids are the chemicals that compose the Cannabis plant. There are over 85 known isolated Cannabinoids in Cannabis. The cannabis plant is a repository for chemicals, there are over 400 chemicals in the entire plant. We are currently working on non-psychoactive cannabinoids, cannabidiol being at the forefront.

 

As we started our work on HE and saw promising results in the area of neuroprotection we sought out another license from the NIH on the same patent to treat CTE (Chronic Traumatic Encephalopathy), in August of 2014 we were granted the additional license. CTE is a concussion related traumatic brain disease with long term effects mostly suffered by contact sports players including football, hockey, soccer, lacrosse, boxing and active military soldiers.

 

To date we are the only license holders of the US Government held patent on cannabinoids.

 

 

LPBI: How long has this project been going on?

 

We have been working on the overall project since 2010. We first started work on early research for CTE in early-2013.

 

 

LPBI: Tell me about the project. What are the goals?

 

Our focus has always been on treating diseases that effect the Brain. Currently we are looking for solutions in therapeutic agents designed to reduce oxidative stress, and act as immuno-modulators and neuroprotectants.

 

KannaLife has an overall commitment to discover and understand new phytochemicals. This diversification of scientific and commercial interests strongly indicates a balanced and thoughtful approach to our goals of providing standardized, safer and more effective medicines in a socially responsible way.

 

Currently our research has focused on the non-psychoactive cannabidiol (CBD). Exploring the appropriate uses and limitations and improving its safety and Metered Dosing. CBD has a limited therapeutic window and poor bioavailability upon oral dosing, making delivery of a consistent therapeutic dose challenging. We are also developing new CBD-like molecules to overcome these limitations and evaluating new phytochemicals from non-regulated plants.

 

KannaLife’s research is led by experienced pharmaceutically trained professionals; Our Scientific team out of the Pennsylvania Biotechnology Center is led by Dr. William Kinney and Dr. Douglas Brenneman both with decades of experience in pharmaceutical R&D.

 

 

LPBI: How do cannabinoids help neurological damage? -What sort of neurological damage do they help?

 

Cannabinoids and specifically cannabidiol work to relieve oxidative stress, and act as immuno-modulators and neuroprotectants.

 

So far our pre-clinical results show that cannabidiol is a good candidate as a neuroprotectant as the patent attests to. Our current studies have been to protect neuronal cells from toxicity. For HE we have been looking specifically at ammonia and ethanol toxicity.

 

 

– How did it go from treating general neurological damage to treating CTE? Is there any proof yet that cannabinoids can help prevent CTE? What proof?

 

We started examining toxicity first with ammonia and ethanol in HE and then posed the question; If CBD is a neuroprotectant against toxicity then we need to examine what it can do for other toxins. We looked at CTE and the toxin that causes it, tau. We just acquired the license in August from the NIH for CTE and are beginning our pre-clinical work in the area of CTE now with Dr. Ron Tuma and Dr. Sara Jane Ward at Temple University in Philadelphia.

 

 

LPBI: How long until a treatment could be ready? What’s the timeline?

 

We will have research findings in the coming year. We plan on filing an IND (Investigational New Drug application) with the FDA for CBD and our molecules in 2015 for HE and file for CTE once our studies are done.

 

 

LPBI: What other groups are you working with regarding CTE?

 

We are getting good support from former NFL players who want solutions to the problem of concussions and CTE. This is a very frightening topic for many players, especially with the controversy and lawsuits surrounding it. I have personally spoken to several former NFL players, some who have CTE and many are frightened at what the future holds.

 

We enrolled a former player, Marvin Washington. Marvin was an 11 year NFL vet with NY Jets, SF 49ers and won a SuperBowl on the 1998 Denver Broncos. He has been leading the charge on KannaLife’s behalf to raise awareness to the potential solution for CTE.

 

We tried approaching the NFL in 2013 but they didn’t want to meet. I can understand that they don’t want to take a position. But ultimately, they’re going to have to make a decision and look into different research to treat concussions. They have already given the NIH $30 Million for research into football related injuries and we hold a license with the NIH, so we wanted to have a discussion. But currently cannabinoids are part of their substance abuse policy connected to marijuana. Our message to the NFL is that they need to lead the science, not follow it.

 

Can you imagine the NFL’s stance on marijuana treating concussions and CTE? These are topics they don’t want to touch but will have to at some point.

 

LPBI: Thank you both Dr. Kinney and Mr. Kikis.

 

Please look for future posts in this series on the Philly Biotech Scene on this site

Also, if you would like your Philadelphia biotech startup to be highlighted in this series please contact me or

http://pharmaceuticalintelligence.com at:

sjwilliamspa@comcast.net or @StephenJWillia2  or @pharma_BI.

Our site is read by ~ thousand international readers DAILY and thousands of Twitter followers including venture capital.

 

Other posts on this site in this VIBRANT PHILLY BIOTECH SCENE SERIES OR referring to PHILADELPHIA BIOTECH include:

The Vibrant Philly Biotech Scene: Focus on Computer-Aided Drug Design and Gfree Bio, LLC

RAbD Biotech Presents at 1st Pitch Life Sciences-Philadelphia

The Vibrant Philly Biotech Scene: Focus on Vaccines and Philimmune, LLC

What VCs Think about Your Pitch? Panel Summary of 1st Pitch Life Science Philly

1st Pitch Life Science- Philadelphia- What VCs Really Think of your Pitch

LytPhage Presents at 1st Pitch Life Sciences-Philadelphia

Hastke Inc. Presents at 1st Pitch Life Sciences-Philadelphia

PCCI’s 7th Annual Roundtable “Crowdfunding for Life Sciences: A Bridge Over Troubled Waters?” May 12 2014 Embassy Suites Hotel, Chesterbrook PA 6:00-9:30 PM

Pfizer Cambridge Collaborative Innovation Events: ‘The Role of Innovation Districts in Metropolitan Areas to Drive the Global an | Basecamp Business

Mapping the Universe of Pharmaceutical Business Intelligence: The Model developed by LPBI and the Model of Best Practices LLC

 

 

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Natural Products Chemistry

Writer and Curator: Larry H. Bernstein, MD, FCAP 

 

 

Natural products chemistry or pharmacognosy, the study of the physical, chemical, biochemical and biological properties of drugs, drug substances or potential drugs

or drug substances of natural origin as well as the search for new drugs from natural
sources, is an a tradition in medicine that reaches to a tradition thousands of years
old.  It has to some extent been supplanted by structural organic chemistry, metallo-organic chemistry, and synthetic organic chemistry of families of drugs.  In some
cases, drug failures may be attributed to the inherent failure in a family, and in others
there has been substitution of a drug compound by another with eaqual or greater
potency and less toxicity. A serious confounder has been that medications intended
for a specific effect has either an unfavorable interaction with another class of drugs,
or it has a metabolic reaction with another organ or pathway than the use intended.
That has been the huge impediment to pharmaceutical development.

However, it is important to remember that many of the medications in common use
were originally plant or natural derivatives, e.g., digoxin, Warfarin.

Thymoquinone, an extract of nigella sativa seed oil, blocked pancreatic cancer cell
growth and killed the cells by enhancing the process of programmed cell death
Steve Benowitz  steven.benowitz@jefferson.edu

Researchers at the Kimmel Cancer at Jefferson in Philadelphia have found that
thymoquinone, an extract of nigella sativa seed oil, blocked pancreatic cancer cell
growth and killed the cells by enhancing the process of programmed cell death.
According to Hwyda Arafat, M.D., Ph.D., associate professor of Surgery at
Jefferson Medical College of Thomas Jefferson University, nigella sativa helps treat
a broad array of diseases, including some immune and inflammatory disorders.
Previous studies also have shown anticancer activity in prostate and colon cancers,
as well as antioxidant and anti-inflammatory effects.

Using a human pancreatic cancer cell line, she and her team found that adding
thymoquinone killed approximately 80 percent of the cancer cells. They demonstrated
that thymoquinone triggered programmed cell death in the cells, and that a number of
important genes, including p53, Bax, bcl-2 and p21, were affected. The researchers
found that expression of p53, a tumor suppressor gene, and Bax, a gene that promotes
programmed cell death, was increased, while bcl-2, which blocks such cell death,
was decreased. The p21 gene, which is involved in the regulation of different phases
of the cell cycle, was substantially increased.

In addition, adding thymoquinone to pancreatic cancer cells reduced the production
and activity of enzymes called histone deacetylases (HDACs), which remove the
acetyl groups from the histone proteins, halting the gene transcription process.
Dr. Arafat notes that HDAC inhibitors are a “hot” new class of drugs that interfere
with the function of histone deacetylases, and is being studied as a treatment for
cancer and neurodegenerative diseases.

Extra Virgin Olive Oil Improves Learning and Memory in SAMP8 Mice
SA Farra, TO Price, LJ Dominguez, A Motisi, F Saianoe, et al.
Journal of Alzheimer’s Disease 28 (2012) 81–92
http://dx.doi.org/10.3233/JAD-2011-110662

Polyphenols are potent antioxidants found in extra virgin olive oil (EVOO);
antioxidants have been shown to reverse age- and disease-related learning and
memory deficits. We examined the effects of EVOO on learning and memory
in SAMP8 mice, an age-related learning/memory impairment model
associated with increased amyloid- protein and brain oxidative damage.
We administered EVOO, coconut oil, or butter to 11 month old SAMP8
mice for 6 weeks. Mice were tested in T-maze foot shock avoidance
and one-trial novel object recognition with a 24 h delay. Mice which
received EVOO had improved acquisition in the T-maze and spent
more time with the novel object in one-trial novel object recognition
versus mice which received coconut oil or butter. Mice that received
EVOO had improve T-maze retention compared to the mice that received
butter. EVOO increased brain glutathione levels suggesting reduced
oxidative stress as a possible mechanism. These effects plus increased
glutathione reductase activity, superoxide dismutase activity, and
decreased tissue levels of 4-hydroxynoneal and 3-nitrotyrosine were
enhanced with enriched EVOO (3× and 5× polyphenols concentration).
Our findings suggest that EVOO has beneficial effects on learning
and memory deficits found in aging and diseases, such as those related
to the overproduction of amyloid- protein, by reversing oxidative damage
in the brain, effectsthat are augmented with increasing concentrations
of polyphenols in EVOO.

Synthetic analogues of flavonoids with improved activity against platelet activation
and aggregation as novel prototypes of food supplements
S Del Turco, S Sartini, G Cigni, C Sentieri, S Sbrana, et al.
Food Chemistry 175 (2015) 494–499 http://dx.doi.org/10.1016/j.foodchem.2014.12.005

We investigated the ability of quercetin and apigenin to modulate platelet activation
and aggregation, and compared the observed efficacy with that displayed by their
synthetic analogues 2-phenyl-4H-pyrido[1,2-a]pyrimidin-4-ones, 1–4, and 2,3-
diphenyl-4H-pyrido[1,2-a]pyrimidin-4-ones, 5–7. Platelet aggregation was
explored through a spectrophotometric assay on platelet-rich plasma (PRP)
treated with the thromboxane A2 mimetic U46619, collagen and thrombin in
presence/absence of various bioisosteres of flavonoids (12.5–25–50–100 lM).
The platelet density, (mean platelet component, MPC), was measured by the
Advia 120 Hematology System as a marker surrogate of platelet activation. The
induced P-selectin expression, which reflects platelet degranulation/activation,
was quantified by flow cytometry on PRP. Our synthetic compounds modulated
significantly both platelet activation and aggregation, thus turning out to be more
effective than the analogues quercetin and apigenin when tested at a
concentration fully consistent with their use in vivo. Accordingly, they might
be used as food supplements to increase the efficacy of natural flavonoids.

Polysaccharide Extracts From Sargassum Siliquosum J.G. Agardh Modulates
Production Of Pro-Inflammatory Cytokines In Lps-Induced Pbmc And Delays
Coagulation Time In-Vitro
RD Vasquez, RSP Garcia-Meim and JDA Ramos
Jour. Harmo. Res. Pharm., 2014, 3(3), 101-112  www.johronline.com

Sulfated polysaccharides from brown seaweeds exhibit various biological activities,
structural diversity, and are potential reagents for the development of therapeutic
drugs. This study aimed to determine the effect of aqueous and fucoidan extracts from
Sargassum siliquosum J. G. Agardh on viability of peripheral blood mononuclear
cells, production of pro-inflammatory cytokines and plasma coagulation using
in vitro
assays. Sulfate contents of the polysaccharides were quantified using Acid-Ashing Digestion Ion chromatography. Effect on viability of the extracts on
peripheral blood mononuclear cells was determined by MTT Assay. Estimation
of pro-inflammatory cytokines concentrations was done through Enzyme-Linked
Immunosorbent Assay, while anticoagulant activity was measured by Prothrombin
Time and Activated Partial Thromboplastin Time. Results revealed that both
extracts were non-cytotoxic to PBMCs, reduced significantly the production of
IL-1, IL-6,TNF-α and exhibited normal anticoagulant activity in PT assays and
prolonged APTT remarkably in dose-dependent manner. In conclusion, extracts
of the Sargassum siliquosum J.G. Agardh is a potential alternative source in
producing anti-inflammatory and anticoagulant substances in the future.

Purple corn anthocyanins inhibit diabetes-associated glomerular monocyte
activation and macrophage infiltration
Min-Kyung Kang, J Li, Jung-Lye Kim, Ju-Hyun Gong, Su-Nam Kwak, JHY Park, et al.
Am J Physiol Renal Physiol 303: F1060–F1069
http://dx.doi.org:/10.1152/ajprenal.00106.2012

Purple corn anthocyanins inhibit diabetes-associated glomerular monocyte activation
and macrophage infiltration. Diabetic nephropathy  (DN) is one of the major diabetic
complications and the leading cause of end- stage renal disease. In early DN, renal
injury and macrophage accumulation take place in the pathological environment
of glomerular vessels adjacent to renal mesangial cells expressing proinflammatory
mediators. Purple corn utilized as a daily food is rich in anthocyanins exerting
disease-preventive activities as a functional food. This study elucidated whether
anthocyanin-rich purple corn extract (PCA) could suppress monocyte activation and
macrophage infiltration. In the in vitro study, human endothelial cells and THP-1 monocytes were cultured in conditioned media of human mesangial cells exposed
to 33 mM glucose (HG-HRMC). PCA decreased the HG-HRMC-conditioned, media-induced expression of endothelial vascular cell adhesion molecule-1, E-selectin,
and monocyte integrins- and -2 through blocking the mesangial Tyk2 pathway. In the
in vivo animal study, db/db mice were treated with 10 mg/kg PCA daily for 8 wk. PCA
attenuated CXCR2 induction and the activation of Tyk2 and STAT1/3 in db/db mice.
Periodic acid-Schiff staining showed that PCA alleviated mesangial expansion-elicited renal injury in diabetic kidneys. In glomeruli, PCA attenuated the induction
of intracellular cell adhesion molecule-1 and CD11b. PCA diminished monocyte
chemoattractant protein-1 expression and macrophage inflammatory protein 2
transcription in the diabetic kidney, inhibiting the induction of the macrophage
markers CD68 and F4/80. These results demonstrate that PCA antagonized
the infiltration and accumulation of macrophages in diabetic kidneys through
disturbing the mesangial IL-8-Tyk-STAT signaling pathway. Therefore, PCA may
be a potential renoprotective agent treating diabetes-associated glomerulosclerosis.

Proximate analysis, phytochemical screening, and total phenolic and flavonoid
contentof Philippine bamboo Schizostachyum lumampao
JVV Tongco, RM Aguda and RA Razal.
Journal of Chemical and Pharmaceutical Research, 2014, 6(1):709-713
www.jocpr.com

In Asia, bamboo has been widely cultivated as a fast growing non-timber forest
species. Flavonoids and phenolics were shown to reduce inflammation, promote
overall cardiovascular health and circulation, and even protect against certain kinds
of cancer. These studies necessitate the chemical characterization (e.g., proximate
analysis) and qualitative identification of phenolics.

The chemical composition of the leaves of Schizostachyum lumampao, known as
“buho” in the Philippines, was determined for its potential use as herbal tea with
potential health benefits, such as antioxidant properties. Proximate analysis using
standard AOAC methods showed that the air-dried leaves contain 10 % moisture, 30.5 % ash, 22.1 % crude protein, 1.6 % crude
fat, 28.7 % crude fiber, and 7.2 % total sugar (by difference). Using a variety of
reagents for qualitative phytochemical screening, saponins, diterpenes, triterpenes,
phenols, tannins, and flavonoids were detected in both the ethanolic and aqueous
leaf extracts, while phytosterols were only detected in the ethanolic extract. Using
UV-Vis spectrophotometry, the total phenolic content (in GAE) were 76.7 and
13.5 gallic acid equivalents per 100 g air-dried sample for the ethanolic and
aqueous extracts, respectively. The total flavonoid content were 70.2 and 17.86 mg
quercetin equivalents per 100 g air-dried sample for the ethanolic and aqueous
extracts, respectively. This preliminary study showed the total amount of phenolics
and flavonoids present in buho, the phytochemicals present, and its proximate
analysis.

Ophiopogonin D: A new herbal agent against osteoporosis
Q Huang, B Gao, L Wang, Hong-Yang Zhang, Xiao-Jie Li, J Shi, Z Wang, et al.
Bone 74 (2015) 18–28
http://dx.doi.org/10.1016/j.bone.2015.01.002

Excessive reactive oxygen species (ROS) play an important role in the development
of osteoporosis. Ophiopogonin D (OP-D), isolated from the traditional Chinese
herbal agent Radix Ophiopogon japonicus, is a potent anti-oxidative agent. We
hypothesized that OP-D demonstrates anti-osteoporosis effects via decreasing
ROS generation in mouse pre-osteoblast cell line MC3T3-E1 subclone 4 cells
and a macrophage cell line RAW264.7 cells. We investigated OP-D on osteogenic
and osteoclastic differentiation under oxidative status. Hydrogen peroxide (H2O2)
was used to establish an oxidative damage model. In vivo, we established a murine
ovariectomized (OVX) osteoporosis model. Then, we searched the molecular
mechanism of OP-D against osteoporosis. Our results revealed that OP-D
significantly promoted the proliferation of MC3T3-E1 cells and improved some
osteogenic markers. Moreover, OP-D reduced TRAP activity and the mRNA
expressions of osteoclastic genes in RAW264.7 cells. OP-D suppressed ROS
generation in both MC3T3-E1 and RAW264.7 cells. OP-D treatment reduced
the activity of serum bone degradation markers, including CTX-1 and TRAP.
Further research showed that OP-D displayed anti-osteoporosis effects via
reducing ROS through the FoxO3a-β-catenin signaling pathway. In summary,
our results indicated that the protective effects of OP-D against osteoporosis
are linked to a reduction in oxidative stress via the FoxO3a-β-catenin signaling
pathway, suggesting that OP-D may be a beneficial herbal agent in bone-related
disorders, such as osteoporosis.

Revealing the macromolecular targets of complex natural products
D Reker, AM Perna, T Rodrigues, P Schneider, M Reutlinger, et al.
Nature Chemistry Dec  2014; 6: 1072 – 1078
http://dx.doi.org:/10.1038/NCHEM.2095

Natural products have long been a source of useful biological activity for the
development of new drugs. Their macromolecular targets are, however, largely
unknown, which hampers rational drug design and optimization. Here we present
the development and experimental validation of a computational method for the
discovery of such targets. The technique does not require three-dimensional
target models and may be applied to structurally complex natural products. The
algorithm dissects the natural products into fragments and infers potential
pharmacological targets by comparing the fragments to synthetic reference drugs
with known targets. We demonstrate that this approach results in confident
predictions. In a prospective validation, we show that fragments of the potent
antitumour agent archazolid A, a macrolide from the myxobacterium Archangium
gephyra, contain relevant information regarding its polypharmacology.
Biochemical and biophysical evaluation confirmed the predictions. The results
obtained corroborate the practical applicability of the computational approach to
natural product ‘de-orphaning’.

In vitro activity of Inula helenium against clinical Staphylococcus aureus strains
including MRSA
O’Shea S, Lucey B, Cotter L.
Br J Biomed Sci. 2009;66(4):186-9.

The present study aims to investigate the bactericidal activity (specifically
antistaphylococcal) of Inula helenium. The antimicrobial activity of the extract is
tested against 200 clinically significant Irish Staphylococcus aureus isolates
consisting of methicillin-resistant (MRSA) and -sensitive (MSSA) S. aureus
using a drop test method and a microbroth dilution method. The antibacterial
effect is evaluated by measuring the area of the inhibition zone against the
isolates. Results proved I. helenium to be 100% effective against the 200
staphylococci tested, with 93% of isolates falling within the ++ and +++ groups.
The minimum bactericidal concentration of I. helenium was examined on a subset
of isolates and values ranged from 0.9 mg/mL to 9.0 mg/mL. The extract was
equally effective against antibiotic-resistant and -sensitive strains. This plant
therefore possesses compounds with potent antistaphylococcal properties, which
in the future could be used to complement infection control policies and prevent
staphylococcal infection and carriage. This research supports other studies
wherein herbal plants exhibiting medicinal properties are being examined to
overcome the problems of antibiotic resistance and to offer alternatives in the
treatment and control of infectious diseases.

Inhibition of Proliferation of Breast Cancer Cells MCF7 and MDA-MB-231 by Lipophilic Extracts of Papaya (Carica papaya L. var. Maradol) Fruit
LE Gayosso-García Sancho, EM Yahia, P García-Solís, GA González-Aguilar
Food and Nutrition Sciences, 2014, 5, 2097-2103
http://dx.doi.org/10.4236/fns.2014.521222

Several epidemiological studies have suggested that carotenoids have
antineoplasic activities. The objective of this study was to determine the
antiproliferative effect of rich carotenoid lipophilic extracts of papaya fruit
pulp (Carica papaya L., cv Maradol) in breast cancer cells, MCF-7 (estrogen
receptor positive) and MDA-MB-231 (estrogen receptor negative), and in
non-tumoral mammary epithelial cells MCF-12F. Antiproliferative effect
was evaluated using the methyl-thiazolydiphenyl-tetrazolium bromide
(MTT) assay and testing lipophilic extracts from different papaya fruit
ripening stages (RS1, RS2, RS3, RS4), at different times (24, 48 and
72 h). Papaya lipophilic extracts do not inhibit cell proliferation of MCF-12F
and MDA-MB-231 cells. However, MCF-7 cells showed a significant
reduction in proliferation at 72 h with the RS4 papaya extract. Results
suggested that lipophilic extracts had different action mechanisms on
each type of cells and therefore, more studies were required to elucidate
such mechanisms.

In vitro cytotoxic activity of silver nano particle biosynthesized from Colpomenia
sinuosa and Halymenia poryphyroides using DLA and EAC cell lines
Vishnu Kiran M and Murugesan S
World J Pharm Sci 2014; 2(9): 926-930.

This study was conducted to investigate the invitro cytotoxic activity of silver
nanoparticles biosynthesized

from Colpomenia sinuosa and Halymenia poryphyroides using DLA and EAC
cell lines by tryphan blue dye  exclusion technique and MTT assay using Mouse L929 cell lines (Lungs fibroblast). The results of the trypan blue dye exclusion assay indicates that the silver nano particles biosynthesized from
Colpomenia sinuosa and Halymenia poryphyroides inhibits the growth of DLA
and EAC cell lines in a dose dependent manner against the standard drug
Curcumin where the silver nano particle biosynthesized from Colpomenia sinuosa
showed 61.57 % and silver nano particle biosynthesized from Halymenia poryphyroides showed 89.36 % in DLA cell line similarly the silver nanoparticle biosynthesized
from Colpomenia sinuosa showed 81.96 % and silver nanoparticle biosynthesized
from Halymenia poryphyroides 91.45 % in EAC cell line. The results of the MTT
assay indicated the silver nanoparticles biosynthesized from Colpomenia sinuosa
and Halymenia poryphyroides significantly inhibited the proliferation of L929 cells
in dose dependent manner where the silver nanoparticle biosynthesized from
Colpomenia sinuosa showed 37.06 % and silver nanoparticle biosynthesized from
Halymenia poryphyroides showed 100 % against the standard drug Curcumin.

Garlic compound fights source of food-borne illness better than antibiotics
·Better than antibiotics: Garlic compound fights source of food-borne illness
(http://www.wsunews.wsu.edu)

Researchers at Washington State University have found that a compound in garlic
is 100 times more effective than two popular antibiotics at fighting the Campylobacter
bacterium, one of the most common causes of intestinal illness. Their work was
recently published in the Journal of Antimicrobial Chemotherapy.  The discovery
opens the door to new treatments for raw and processed meats and food preparation
surfaces. Most infections stem from eating raw or undercooked poultry or foods
that have been cross-contaminated via surfaces or utensils used to prepare poultry.

Lu and his colleagues looked at the ability of the garlic-derived compound, diallyl
sulfide, to kill the bacterium when it is protected by a slimy biofilm that makes it
,000 times more resistant to antibiotics than the free floating bacterial cell. They
found the compound can easily penetrate the protective biofilm and kill bacterial
cells by combining with a sulfur-containing enzyme, subsequently changing
the enzyme’s function and effectively shutting down cell metabolism. The
researchers found the diallyl sulfide was as effective as 100 times as much
of the antibiotics erythromycin and ciprofloxacin and would often work in a
fraction of the time.

Two previous works published last year by Lu and WSU colleagues in Applied
and Environmental Microbiology and Analytical Chemistry found diallyl sulfide
and other organosulfur compounds effectively kill important foodborne pathogens,
such as Listeria monocytogenes and Escherichia coli O157:H7.

“Diallyl sulfide could make many foods safer to eat”, says Barbara Rasco, a
co-author on all three recent papers and Lu’s advisor for his doctorate in food
science. “It can be used to clean food preparation surfaces and as a preservative
in packaged foods like potato and pasta salads, coleslaw and deli meats”.

Effect of tree nuts on metabolic syndrome criteria: a systematic review and
meta-analysis of randomized controlled trials

SB Mejia, CWC Kendall, E Viguiliouk, LS Augustin, V Ha, AI Cozma, A Mirrahimi, et al.
BMJ Open 2014;4:e004660.  http://dx.doi.org:/10.1136/bmjopen-2013-004660

Objective: To provide a broader evidence summary to inform dietary guidelines of the
effect of tree nuts on criteria of the metabolic syndrome (MetS).
Design: We conducted a systematic review and metaanalysis of the effect of
tree nuts on criteria of the MetS.
Data sources: We searched MEDLINE, EMBASE, CINAHL and the Cochrane Library
(through 4 April 2014).
Eligibility criteria for selecting studies: We included relevant randomized controlled
trials (RCTs) of ≥3 weeks reporting at least one criterion of the MetS.
Data extraction: Two or more independent reviewers extracted all relevant data. Data
were pooled using the generic inverse variance method using random effects models
and expressed as mean differences (MD) with 95% CIs. Heterogeneity was assessed
by the Cochran Q statistic and quantified by the I2 statistic. Study quality and risk of
bias were assessed.
Results: Eligibility criteria were met by 49 RCTs including 2226 participants who
were otherwise healthy or had dyslipidemia, MetS or type 2 diabetes mellitus.
Tree nut interventions lowered triglycerides (MD=−0.06 mmol/L (95% CI −0.09
to −0.03 mmol/L)) and fasting blood glucose (MD=−0.08 mmol/L (95% CI −0.16
to −0.01 mmol/L)) compared with control diet interventions. There was no effect
on waist circumference, high-density lipoprotein cholesterol or blood pressure with
the direction of effect favoring tree nuts for waist circumference. There was
evidence of significant unexplained heterogeneity in all analyses (p<0.05).
Conclusions: Pooled analyses show a MetS benefit of tree nuts through modest
decreases in triglycerides and fasting blood glucose with no adverse effects
on other criteria across nut types. As our conclusions are limited by the short
duration and poor quality of the majority of trials, as well as significant
unexplained between-study heterogeneity, there remains a need for larger,
longer, high-quality trials.

DPPH free radical scavenging activity of phenolics and flavonoids in some medicinal
plants of India
R Patel, Y Patel, P Kunjadia and A Kunjadia
Int.J.Curr.Microbiol.App.Sci (2015) 4(1): 773-780 http://www.ijcmas.com

Methanolic extracts of Gymnema sylvestre (leaf), Holarrhena antidysenterica (bark),
Vernonia anthelmintica(seeds) Enicostemma littorale (leaf), Momordica charantia
(fruit), Swertia chirata (leaf), Azadirachta indica (leaf), Caesalpinia bonducella (leaf)
used in Ayurvedic medicines for number of ailments were evaluated for their
antioxidant activity.The free radical-scavenging activity of the extracts was measured
as decolorizing activity followed by the trapping of the unpaired electron by 1, 1-
diphenyl-2-picryl hydrazyl radical (DPPH). The percentage decrease of DPPH
was recorded maximum in A. indica followed by M. charantia, C. bonducella,
E.littorale, V. anthelmintica, S.chirata, H.antidysenterica, G.sylvestre. The
antioxidant activity of medicinal plants was at par with the commercial antioxidant
like L-Ascorbic acid. Phytochemical analysis revealed the presence of major
phytocompounds like terpenoids, alkaloids, glycosides, phenolics and tannins.
Moreover, total flavonoid concentration equivalents to gallic acid was found in
the range of 326 μg to 1481μg/g of plant extracts and that of total phenolic
concentration equivalents to phenol was found in the range of 23.50 μg to
89.82 μg/g of plant extracts. The findings indicated promising antioxidant
activity of crude extracts of the above plants and needs further exploration
for their effective use in both modern and traditional system of medicines.

Cyanobacterial natural products as antimicrobial agents
V.D. Pandey
Int.J.Curr.Microbiol.App.Sci (2015) 4(1): 310-317 http://www.ijcmas.com

Cyanobacteria (blue-green algae) constitute a morphologically diverse and
widely distributed group of Gram-negative photosynthetic prokaryotes. Possessing
tremendous adaptability to varying environmental conditions, effective protective
mechanisms against various abiotic stresses and metabolic versatility, they colonize
and grow in different types of terrestrial and aquatic habitats. In addition to
the potential applications of cyanobacteria in various fields, such as agriculture,
aquaculture, pollution control, bioenergy and nutraceuticals, they produce chemically
diverse and pharmacologically important novel bioactive compounds, including
antimicrobial compounds (antibacterial, antifungal and antiviral). The emergence
and spread of antibiotic resistance in pathogenic microbes against commonly used
antibiotics necessitated the search for new antimicrobial agents from sources other
than the traditional microbial sources (streptomycetes and fungi). Various features
of cyanobacteria, including their capability of producing antimicrobial compounds,
make them suitable candidates for their exploitation as a natural source
of antimicrobial agents.
Determination of nutritional value and antioxidant from bulbs of different onion
(Allium cepa) variety: A comparative study
Kandoliya, U.K.*, Bodar, N.P., Bajaniya, V.K., Bhadja N.V. and Golakiya, B.A.
Int.J.Curr.Microbiol.App.Sci (2015) 4(1): 635-641 http://www.ijcmas.com

Onion (Allium cepa) is one of the most economically important vegetable crops
consumed for their ability to enhance the added flavor and typical taste in other
foods. It is a good source of antioxidants as well as some phytonutrients.
So the experiment was conducted to study the nutritional quality along with
various parameters contributing antioxidant activity from onion of different red and
white type local varieties. The findings revealed from all the variety studied,
shows 58.14 to 77.67 % DPPH value, comparable amount of flavanoids
(0.422 to 1.232 mg.g-1) and anthocyanine content along with total phenol
(8.96-18.23 mg.100 g-1), Pyruvic acid (1.09 to 1.33 mg.g-1), ascorbic acid
(1.18 to 3.89 mg.100g-1) , protein (0.79 to 1.27%) and titrable acidity
(0.34 0.75%).These results reveal that JDRO-07-13 of Red variety and
GWO-1 of white nutritionally found better due to its higher antioxidant
property, proteins, carbohydrates, reducing sugar and should be included in diets to supplement our daily allowance needed by the body.

Curcumin: New Weapon against Cancer
Fayez Hamam
Food and Nutrition Sciences, 2014, 5, 2257-2264
http://dx.doi.org/10.4236/fns.2014.522239

All the evidences point out to the fact that the incidence, mortality and number of
persons living with cancer are on the rise and, thus, this will impose a significant
burden on health care resources. The considerable number of deaths from cancer
necessitates the need to developing novel alternative cures that are efficient, safe,
cheap and easy to use. In the search for new therapies for tumors, naturally-derived compounds have been considered as a good source of novel anticancer
drugs. The challenge here is to find products that are pharmacologically active
against tumor cells with suitable toxicity profile and least damage to normal cells.
Curcumin is a spice widely used in many countries especially in South Asia and
it has gained importance for its anticancer function and low toxicity toward normal
tissues in a range of biological systems. In spite of significant research works, many
difficulties hinder its oral use in the therapy of different kind of tumors, such as
extreme low solubility in water, quick break down and excretion after being absorbed
in the human body. Low bioavailability due to enhanced metabolism and rapid
system elimination is another problem that hinders oral use of curcumin as
anticancer agent. Therefore, the previously mentioned poor pharmacokinetics
characteristics inhibit curcumin from reaching its site of action and, thus,
lessen its effectiveness against tumors. This article reviews the latest global
cancer statistics with special attention to be directed toward ovarian cancer.
It sheds light on many research works that investigated the protective and
therapeutic functions of different curcumin preparations against different
sites of cancer using animal models. It also summarizes recent
research works concerning the antitumor effects of curcumin alone and/or
loaded into a range of delivery devices in many types of ovarian cancer cell lines.

Cinnamon is lethal weapon against E. coli O157:H7

When cinnamon is in, Escherichia coli O157:H7 is out.  That’s what researchers
at Kansas State University discovered in laboratory tests with cinnamon and
apple juice heavily tainted with the bacteria.  Presented at the Institute of Food
Technologists’ 1999 Annual Meeting in Chicago on July 27, the study findings
revealed that cinnamon is a lethal weapon against  E. coli O157:H7 and may be
able to help control it in unpasteurized juices.

Lead researcher Erdogan Ceylan, M.S., reported that in apple juice samples
inoculated with about one million E. coli O157:H7 bacteria, about one teaspoon
(0.3 percent) of cinnamon killed 99.5 percent of the bacteria in three days at room
temperature (25 C).  When the same amount of cinnamon was combined with
either 0.1 percent sodium benzoate or potassium sorbate, preservatives approved
by the Food and Drug Administration, the E. coli were knocked out to an
undetectable level.  The number of bacteria added to the test samples was
100 times the number typically found in contaminated food.

“If cinnamon can knock out E. coli O157:H7, one of the most virulent foodborne
microorganisms that exists today, it will certainly have antimicrobial effects on other
common foodborne bacteria, such as Salmonella and Campylobacter,” noted Daniel
Y.C. Fung, Ph.D., professor of Food Science in the Department of Animal Sciences
and Industry at K-State, who oversaw the research.

Last year, Fung and Ceylan researched the antimicrobial effects of various spices
on  E. coli O157:H7 in raw ground beef and sausage and found that cinnamon,
clove, and garlic were the most powerful.  This research led to their recent studies
on cinnamon in apple juice, which proved to be a more effective medium than meat
for the spice to kill the bacteria.

“In liquid, the E. coli have nowhere to hide,” Fung noted, “whereas in a solid structure,
such as ground meat, the bacteria can get trapped in the fat or other cells and
avoid contact with the cinnamon.  But this cannot happen in a free-moving environment.”

For a copy of the study presented at IFT’s Annual Meeting, contact Angela Dansby at
312-82-8424 x127 or via e-mail at aldansby@ift.org
Anti-inflammatory, anti-proliferative and anti-atherosclerotic effects of quercetin in
human in vitro and in vivo models
R Kleemann, Lars Verschuren, M Morrison, S Zadelaar, MJ van Erk, PY Wielinga, & T  Kooistra
Atherosclerosis 218 (2011) 44– 52
http://dx.doi.org:/10.1016/j.atherosclerosis.2011.04.023

Objective: Polyphenols such as quercetin may exert several beneficial effects,
including those resulting from anti-inflammatory activities, but their impact on
cardiovascular health is debated. We investigated the effect of quercetin on
cardiovascular risk markers including human C-reactive protein (CRP) and on
atherosclerosis using transgenic humanized models of cardiovascular disease.
Methods: After evaluating its anti-oxidative and anti-inflammatory effects in
cultured human cells, quercetin (0.1%, w/w in diet) was given to human CRP
transgenic mice, a humanized inflammation model, and ApoE*3Leiden transgenic
mice, a humanized atherosclerosis model. Sodium salicylate was used as an
anti-inflammatory reference. Results: In cultured human endothelial cells,
quercetin protected against H2O2-induced lipid peroxidation and reduced the
cytokine-induced cell-surface expression of VCAM-1 and E-selectin. Quercetin
also reduced the transcriptional activity of NFB in human hepatocytes. In human
CRP transgenic mice (quercetin plasma concentration: 12.9 ± 1.3 M), quercetin
quenched IL1-induced CRP expression, as did sodium salicylate. In ApoE*3 Leiden mice, quercetin (plasma concentration: 19.3 ± 8.3 M) significantly attenuated
atherosclerosis by 40% (sodium salicylate by 86%). Quercetin did not affect
atherogenic plasma lipids or lipoproteins but it significantly lowered the circulating
inflammatory risk factors SAA and fibrinogen. Combined histological and microarray
analysis of aortas revealed that quercetin affected vascular cell proliferation thereby
reducing atherosclerotic lesion growth. Quercetin also reduced the gene expression
of specific factors implicated in local vascular inflammation including IL-1R, Ccl8, IKK,
and STAT3.
Conclusion: Quercetin reduces the expression of human CRP and cardiovascular risk
factors (SAA, fibrinogen) in mice in vivo. These systemic effects together with local
anti-proliferative and anti-inflammatory effects in the aorta may contribute to the
attenuation of atherosclerosis.
Natural products to drugs: natural product derived compounds in clinical trials
Mark S. Butler
Nat  Prod  Rep  2005; 22 : 162 – 195 http://dx.doi.org:/10.1039/b402985m

Natural product and natural product-derived compounds that are being
evaluated in clinical trials or in registration (current 31 December 2004)
have been reviewed. Natural product derived drugs launched in the
United States of America, Europe and Japan since 1998 and new
natural product templates discovered since 1990 are discussed.

Natural Products (NPs) traditionally have played an important role in drug discovery
and were the basis of most early medicines. Over the last 10 to 15 years advances
in X-ray crystallography and NMR, and alternative drug discovery methods such as
rational drug design and combinatorial chemistry have placed great pressure upon
NP drug discovery programs and during this period most major pharmaceutical
companies have terminated or considerably scaled down their NP operations.
However, despite the promise of these alternative drug discovery methods, there is
still a shortage of lead compounds progressing into clinical trials. This is especially
the case in therapeutic areas such as oncology, immunosuppression and metabolic
diseases where NPs have played a central role in lead discovery. In a recent review,
Newman,Cragg and Snader analysed the number of NP-derived drugs present in
the total drug launches from 1981 to 2002 and found that NPs were a significant
source of these new drugs, especially in the oncological and antihypertensive
therapeutic areas. In addition to providing many new drug leads, NPs and NP-derived drugs were well represented in the top 35 worldwide selling ethical drugs
in 2000, 2001 and 2002.

Antibacterial activity of green tea (Camellia sinensis) Extract against dental
caries and other pathogens
P. Lavanya and M. Sri priya
Int.J.Adv. Res.Biol.Sci.2014; 1(5):58-70

The present study has however, revealed that the herbal plant Camellia sinensis (green tea) possess antimicrobial properties. The isolated strains were confirmed by performing staining and biochemical techniques. Aqueous extract of green tea were taken and used for the study of inhibition effect against dental caries and
other pathogens. The zone of inhibition was performed using agar well diffusion techniques different concentration of green tea extracts were studied for their
antibacterial activity. The overall results showed that the microorganisms
were susceptible to different concentration of aqueous extracts of Camellia
sinensis which is a function of their antimicrobial properties. The effectiveness of active principle was studied and compared with the previous one. The nature
of the chemicals present as active principle of the extract was studied using
Paper chromatography and Thin layer chromatography. The chemicals involved in
antimicrobial activity are commonly belonging to any one of the group such as flavanoids, alkaloids, saponins and polyphenols. It could be concluded
that flavonoid in a potential natural, antimicrobial agent against dental
caries and other pathogens.

Antibacterial activity of Mangrove Medicinal Plants against Gram positive
Bacterial pathogens
K. A. Selvam* and K. Kolanjinathan
Int. J. Adv. Res. Biol.Sci. 1(8): (2014): 234–241

Ten mangrove medicinal plants viz., Avicennia marina, Rhizophora mucuronata, Rhizophora mangle, Asparagus officinalis, Ceriops decandra, Aegiceras
corniculatum, Acanthus ilicifolius, Bruguiera cylindrica, Rhizophora apiculata and Xylocarpus grantum were collected from mangrove forest of Pichavaram, Tamil
Nadu, India. The antibacterial activity of mangrove plant extracts (150 mg/ml and
300 mg/ml) were determined by Disc diffusion method. The zone of inhibition was more at 300 mg/ml of extracts when compared to 150 mg/ml of extracts. The
antibacterial activity of selected mangrove plant leaf extracts was determined
against pathogenic bacterial isolates. The methanol extract of Ceriops decandra showed maximum zone of inhibition against all the bacterial isolates followed
by Avicennia marina, Rhizophora mucronata, Aegiceras corniculatum, Rhizophora apiculata, Rhizophora mangle, Acanthus ilicifolius, Asparagus officinalis, Xylocarpus grantum and Bruguiera cylindrica at 300 mg/ml. The hexane extract of mangrove plants showed minimum inhibition zone against bacterial pathogens
when compared to the other solvent extracts. The DMSO was used as a blind
control and the antibiotic Ampicillin (300 mg/ml) was used as a positive control. Minimum inhibitory concentration (MIC) of the mangrove plant extracts against bacterial isolates was tested in Mueller Hinton broth by Broth macro dilution
method. The MIC of mangrove plants against bacterial pathogens was ranged
between 20 mg/ml to 640 mg/ml.

Antioxidant and antibacterial activity of Berberis tinctoria root
Karthikkumar Va, Sharanya R , Allegendiran R, Sasikumar J.M
Int. J. Adv. Res. Biol.Sci. 1(9): (2014): 292–297
Herbs have always been the principle form of medicine in developing nations
and presently they are becoming popular throughout the developed world as
people strive to stay healthy in the face of chronic stress and to treat illness with medicines that work in concert with body’s own defences. The aim of the present study was to evaluate the antioxidant and antibacterial potential of Bereris
tinctoria root. Plant material collected and extracted with various solvents. Different concentrations of extracts were used to evaluate the potential. Bereberis tinctoria
root at a concentration of 1000μg/ml shows high antioxidant activity and relatively
all extracts possessing strong to moderate antibacterial activity. In addition, during phytochemical screening, we got saponins and sterols from its root, when extracting with organic solvents. Thus, root extract of Berberis tinctoria might be good
candidate for the synthesis of antibacterial drugs in the future.

Biological Activities of Soybean Galactomannan Oligosaccharides and
Their Sulfated Derivatives
MMI Helal, SA Ismail, MOI Ghobashy, SS Elgazar, et al.
Int.J.Adv. Res.Biol.Sci.2014; 1(6):113-121

Galactomanno-oligosaccharieds (GMO) and their sulfated derivatives
(SGMO) were prepared from soybean hulls and evaluated for their biological
activities as anticoagulant; antimicrobial; antitumor; fibrinolytic and prebiotics.
The results indicated that the sulfating process has positive effect on the
anticoagulation and fibrinolytic activities of the galactomanno-oligosaccharides.
The SGMO have prolonged clotting time more than 24h at concentration resemble that of the standard heparin. It was also found that the SGMO have fibrinolytic
activity as that of the standard hemoclar and 3 times higher than that of the native GMO oligosaccharides. The prepared oligosaccharides also preformed anti-tumor
activity against human colon carcinoma cell line and the percentage of the dead cells increase from 28% to 72% by increase the concentration of the oligosaccharides from 0.005 to 0.02 mg/ml. The tested galactomanno-oligosaccharides also act as good source for prebiotic as they have the ability to grow the beneficial bacteria
4 to 8 times higher than the pathogenic one. To our knowledge this is the first
time someone report anticoagulation; fibrinolytic and direct antitumor activities for galactomanno-oligosaccharides not to mention soybean galactomanno-oligosaccharides.

Biotechnological Application of Production β-Lactamase Inhibitory Protein
(BLIP) By Actinomycetes Isolates from Al-Khurmah Governorate
HM Atta;  RA Bayoumi and  MH El-Sehrawi
Int. J. Adv. Res. Biol.Sci. 1(7): (2014): 144–154

Many pathogenic bacteria secrete β-lactamase enzymes as a mechanism of
defense against β-lactam antibiotics. Sixty-nine unrepeated actinomycetes
isolates were isolated from different localities in Al-Khurmah governorate, Saudi Arabia kingdom. Actinomycetes isolates were screened for producing β-lactamase inhibitory effect against amoxicillin –resistant bacteria. There were eleven isolates (15.94 %) which had β-lactamase inhibitory protein (BLIP) effect against amoxicillin –resistant Staphylococcus aureus, pseudomonas aeruginosa and Klebsiella
pneumonia. The KH-3201-144 isolate has been considered the most potent, this
was identified by biochemical, chemotaxonomic, morphological and physiological properties consistent with classification in the genus Streptomyces, with the
nearest species being Streptomyces rimosus. Furthermore, a phylogenetic
analysis of the 16S rDNA gene sequence and ribosomal database project
consistent with conventional taxonomy confirmed that strain KH-3201-144
was most similar to Streptomyces rimosus (96%). The highest amount of
β-lactamase inhibitory protein was precipitated at 40% of saturated ammonium sulphate. The purification was carried out by using both diethyl-aminoethyl-cellulose G-25 and sephadex G-200 column chromatography, respectively.
The β-lactamase inhibitory protein was separated at 40 KDa. The minimum
inhibition concentrations “MICs” of the purified β-lactamase inhibitory protein
(BLIP) effect against amoxicillin –resistant Staphylococcus aureus, pseudomonas aeruginosa and Klebsiella pneumonia were also determined.

Bioactive compounds from marine Microbes
P.Sudhasupriya and M.Rajalakshmi
Int.J.Adv. Res.Biol.Sci.2014; 1(6):232-236

Natural compounds isolated from marine organisms have been found to be
a very rich source of bioactive molecules. Reported biological effects of these compounds include anti‐tumor, anti-inflammatory and anti‐viral activities as
well as immunomodulatory and analgesic properties. Pharmaceutical market is growing rapidly and continuously. But, still the demand for new drug discovery
is encouraged. The reason behind this motivation can be the growing number
of drug–resistant infectious diseases and more and more upcoming disorders. Pharmaceutical market is growing rapidly and continuously. But, still the demand
for new drug discovery is encouraged. The reason behind this motivation can
be the growing number of drug–resistant infectious diseases and more and more upcoming disorders.

The Discovery and Properties of Avemar – Fermented Wheat Germ
Extract: Carcinogenesis Suppressor
Larry H Bernstein, MD, FCAP, Contributor
http://pharmaceuticalintelligence.com/2014/06/07/the-discovery-
and-properties-of-avemar-fermented-wheat-germ-extract-
carcinogenesis-suppressor/

Read Full Post »

More Complexity in Protein Evolution

Author and Curator: Larry H. Bernstein, MD, FCAP 

Lactate dehydrogenase like crystallin: a potentially protective shield for Indian spiny-tailed lizard (Uromastix ltardwickit) lens against environmental stress?
A Atta, A Ilyas, Z Hashim, A Ahmed and S Zarina
The Protein Journal 2014; 33(2), p. 128-34.
http://dx.doi.org/10.1007/s10930-014-9543-4

Taxon specific lens crystallins in ve1iebrates are either similar or identical with various metabolic enzymes. These bifunctional crystallins serve as structural protein in lens along with their catalytic role. In the present study, we have partially purified and characterized lens crystallin from Indian spiny-tailed lizard (Uroma stix hardwickii). We have found lactate dehydrogenase (LDH) activity in lens indicating presence of an enzyme crystallin with dual functions. Taxon specific lens crystallins are product of gene sharing or gene duplication phenomenon where a pre-existing enzyme is recruited as lens crystallin in addition to structural role. In lens, same gene adopts refractive role in lens without modification or loss of pre-existing function during gene sharing phenomenon. Apart from conventional role of structural protein, LDH activity containing crystallin in Uromastix hardwickii lens is likely to have adaptive characteristics to offer protection against toxic effects of oxidative stress and ultraviolet light, hence justifying its recruitment. Taxon specific crystallins may serve as good models to understand structure-function relationship of these proteins.

αB-Crystallin and 27-kd Heat Shock Protein Are Regulated by Stress Conditions in the Central Nervous System and Accumulate in Rosenthal Fibers
T Iwaki, A Iwaki, J Tateishi, Y Sakaki, and JE Goldmant
Ameri J Pathol  1993; 143(2):487-495.

To understand the significance of the accumulation of αB-crystallin in Rosenthal fibers within astrocytes, the expression and metabolism of αB-crystallin in glioma cell lines were examined under the conditions of heat and oxidative stress. αB-crystallin mRNA was increased after both stresses, and αB-crystallin protein moved from a detergent-soluble to a detergent-insoluble form. In addition, Western blotting of Alexander’s  disease brain homogenates revealed that the 27-kd heat shock protein (HSP27), which is related to αB-crystallin, accumulates along with αB-crystallin. The presence of HSP27 in Rosenthal fibers was directly demonstrated by immunohistochemistry. Our results suggest that astrocytes in Alexander’s disease may be involved in an as yet unknown kind of stress reaction that causes the accumulation of αB-ccystallin and HSP27 and results in Rosenthal fiber formation.

α-Crystallin can function as a molecular chaperone
Joseph Horwitz
Proc. Nadl. Acad. Sci. USA Nov 1992; 89: 10449-10453. Biochemistry

The α-crystallins (αA and αB) are major lens structural proteins of the vertebrate eye that are related to the small heat shock protein family. In addition, crystallins (especially αB) are found in many cells organs outside the lens, and aα is overexpressed in several neurological disorders and in cell lines under stress conditions. Here I show that α-crystallin can function as a molecular chaperone. Stoichiometric amounts of αA and αB suppress thermally induced aggregation of various enzymes. In particular, α-crystalln is very efficient in suppressing the thermally induced aggregation of β- and y-crystallins, the two other major mammalian stuctural lens proteins. α-Crystallin was also effective in preventing aggregation and in refolding guanidine hydrochloride-denatured y-crystallin, as judged by circular dichroism spectroscopy. My results thus indicate that α-crystallin refracts light and protects proteins from aggregation in the transparent eye lens and that in nonlens cells α-crystallin may have other functions in addition to its capacity to suppress aggregation of proteins.

Gene sharing by δ-crystallin and argininosuccinate Iyase
J Piatigorsky, WE O’Brient, BL Norman, K Kalumuckt, GJ Wistow, T Borras, et al.
Proc. Natl. Acad. Sci. USA  May 1988; 85: 3479-3483. Evolution.

The lens structural protein δ-crystallin and the metabolic enzyme argininosuccinate lyase (ASL; Largininosuccinate argine-lyase, EC 4.3.2.1) have striking sequence similarity. We have demonstrated that duck δ-crystallin has enormously high ASL activity, while chicken δ-crystallin has lower but significant activity. The lenses of these birds had much greater ASL activity than other tissues, suggesting that ASL is being expressed at unusually high levels as a structural component. In Southern blots of human genomic DNA, chicken δ1-crystallin cDNA hybridized only to the human ASL gene; moreover, the two chicken δ-crystallin genes accounted for all the sequences in the chicken genome able to cross-hybridize with a human ASL cDNA, with preferential hybridization to the δ2 gene. Correlations of enzymatic activity and recent data on mRNA levels in the chicken lens suggest that ASL activity depends on expression of the δ2-crystallin gene. The data indicate that the same gene, at least in ducks, encodes two different functions, an enzyme (ASL) and a structural protein (δ-crystallin), although in chickens specialization and separation of functions may have occurred.

Gecko i-crystallin: How cellular retinol-binding protein became an eye lens ultraviolet filter
PJ L Werten, Beate Roll, DMF van Aalten, and WW de Jong
PNAS Mar 2000; 97(7): 3282–3287 http://pnas.org/cgi/doi/10.1073ypnas.050500597

Eye lenses of various diurnal geckos contain up to 12% i-crystallin. This protein is related to cellular retinol-binding protein type I (CRBP I) but has 3,4-didehydroretinol, rather than retinol, as a ligand. The 3,4-didehydroretinol gives the lens a yellow color, thus protecting the retina by absorbing short-wave radiation. i-Crystallin could be either the gecko’s housekeeping CRBP I, recruited for an additional function in the lens, or the specialized product of a duplicated CRBP I gene. The finding of the same CRBP I-like sequence in lens and liver cDNA of the gecko Lygodactylus picturatus now supports the former option. Comparison with i-crystallin of a distantly related gecko, Gonatodes vittatus, and with mammalian CRBP I, suggests that acquiring the additional lens function is associated with increased amino acid changes. Compared with the rat CRBP I structure, the i-crystallin model shows reduced negative surface charge, which might facilitate the required tight protein packing in the lens. Other changes may provide increased stability, advantageous for a long-living lens protein, without frustrating its role as retinol transporter outside the lens. Despite a number of replacements in the ligand pocket, recombinant i-crystallin binds 3,4-didehydroretinol and retinol with similar and high affinity (1.6 nM). Availability of ligand thus determines whether it binds 3,4-didehydroretinol, as in the lens, or retinol, in other tissues. i-Crystallin presents a striking example of exploiting the potential of an existing gene without prior duplication.

Expression of βA3/A1-crystallin in the developing and adult rat eye
G Parthasarathy, Bo Ma, C Zhang, C Gongora, JS Zigler, MK Duncan, D Sinha
J Molec Histol 2011; 42(1): 59-69. http://dx.doi.org:/10.1007/s10735-010-9307-1

Crystallins are very abundant structural proteins of the lens and are also expressed in other tissues. We have previously reported a spontaneous mutation in the rat βA3/A1-crystallin gene, termed Nuc1, which has a novel, complex, ocular phenotype. The current study was undertaken to compare the expression pattern of this gene during eye development in wild type and Nuc1 rats by in situ hybridization (ISH) and immunohistochemistry (IHC).
βA3/A1-crystallin expression was first detected in the eyes of both wild type and Nuc1 rats at embryonic (E) day 12.5 in the posterior portion of the lens vesicle, and remained limited to the lens fibers throughout fetal life.
After birth, βA3/A1-crystallin expression was also detected in the neural retina (specifically in the astrocytes and ganglion cells) and in the retinal pigmented epithelium (RPE).
This suggested that βA3/A1-crystallin is not only a structural protein of the lens, but has cellular function(s) in other ocular tissues.
In summary, expression of βA3/A1-crystallin is controlled differentially in various eye tissues with lens being the site of greatest expression.
Similar staining patterns, detected by ISH and IHC, in wild type and Nuc1 animals suggest that functional differences in the protein, rather than changes in mRNA/protein level of expression likely account for developmental abnormalities in Nuc1.

βA3/A1Crystallin controls anoikis-mediated cell death in astrocytes by modulating PI3K/AKT/mTOR and ERK survival pathways through the PKD/Bit1-signaling axis
B Ma, T Sen, L Asnaghi, M Valapala, F Yang, S Hose, D S McLeod, Y Lu, et la.
Cell Death and Disease 2011; 2(10). http://dx.doi.org:/10.1038/cddis.2011.100

During eye development, apoptosis is vital to the maturation of highly specialized structures such as the lens and retina. Several forms of apoptosis have been described, including anoikis, a form of apoptosis triggered by inadequate or inappropriate cell–matrix contacts. The anoikis regulators, Bit1 (Bcl-2 inhibitor of transcription-1) and protein kinase-D (PKD), are expressed in developing lens when the organelles are present in lens fibers, but are downregulated as active denucleation is initiated.
We have previously shown that in rats with a spontaneous mutation in the Cryba1 gene, coding for βA3/A1-crystallin, normal denucleation of lens fibers is inhibited. In rats with this mutation (Nuc1), both Bit1 and PKD remain abnormally high in lens fiber cells. To determine whether βA3/A1-crystallin has a role in anoikis, we induced anoikis in vitro and conducted mechanistic studies on astrocytes, cells known to express βA3/A1-crystallin.
The expression pattern of Bit1 in retina correlates temporally with the development of astrocytes. Our data also indicate that loss of βA3/A1-crystallin in astrocytes results in a failure of Bit1 to be trafficked to the Golgi, thereby suppressing anoikis. This loss of βA3/A1-crystallin also induces insulin-like growth factor-II, which increases cell survival and growth by modulating the phosphatidylinositol-3-kinase (PI3K)/AKT/mTOR and extracellular signal-regulated kinase pathways. We propose that βA3/A1-crystallin is a novel regulator of both life and death decisions in ocular astrocytes.

βA3/A1-crystallin in astroglial cells regulates retinal vascular remodeling during development
D Sinha, A Klise, Y Sergeev, S Hose, IA Bhutto, L Hackler Jr., T Malpic-llanos, et al.
Molec Cell Neurosci 2008; 37(1): 85-95.

http://dx.doi.org:/10.1016/j.mcn.2007.08.016

Vascular remodeling is a complex process critical to development of the mature vascular system. Astrocytes are known to be indispensable for initial formation of the retinal vasculature; our studies with the Nuc1 rat provide novel evidence that these cells are also essential in the retinal vascular remodeling process.
Nuc1 is a spontaneous mutation in the Sprague–Dawley rat originally characterized by nuclear cataracts in the heterozygote and microphthalmia in the homozygote. We report here that the Nuc1 allele results from mutation of the βA3/A1-crystallin gene, which in the neural retina is expressed only in astrocytes. We demonstrate striking structural abnormalities in Nuc1 astrocytes with profound effects on the organization of intermediate filaments. While vessels form in the Nuc1 retina, the subsequent remodeling process required to provide a mature vascular network is deficient. Our data implicate βA3/A1-crystallin as an important regulatory factor mediating vascular patterning and remodeling in the retina.

A developmental defect in astrocytes inhibits programmed regression of the hyaloid vasculature in the mammalian eye
C Zhang, L Asnaghi, C Gongora, B Patek, S Hose, Bo Ma, MA Fard, L Brako, et al.
Eur J Cell Biol 2011; 90(5): 440-448.
http://dx.doi.org:/10.1016/j.ejcb.2011.01.003

Previously we reported the novel observation that astrocytes ensheath the persistent hyaloid artery, both in the Nuc1 spontaneous mutant rat, and in human PFV (persistent fetal vasculature) disease (Developmental Dynamics 234:36–47, 2005). We now show that astrocytes isolated from both the optic nerve and retina of Nuc1 rats migrate faster than wild type astrocytes. Aquaporin 4 (AQP4), the major water channel in astrocytes, has been shown to be important in astrocyte migration. We demonstrate that AQP4 expression is elevated in the astrocytes in PFV conditions, and we hypothesize that this causes the cells to migrate abnormally into the vitreous where they ensheath the hyaloid artery. This abnormal association of astrocytes with the hyaloid artery may impede the normal macrophage-mediated remodeling and regression of the hyaloid system.

βA3/A1-crystallin is required for proper astrocyte template formation and vascular remodeling in the retina.
D Sinha; WJ Stark; M Valapala; IA Bhutto; M Cano; S Hose; GA Lutty; et al.  Transgenic research 2012; 21(5):1033-42.

Nuc1 is a spontaneous rat mutant resulting from a mutation in the Cryba1 gene, coding for βA3/A1-crystallin. Our earlier studies with Nuc1 provided novel evidence that astrocytes, which express βA3/A1-crystallin, have a pivotal role in retinal remodeling. The role of astrocytes in the retina is only beginning to be explored. One of the limitations in the field is the lack of appropriate animal models to better investigate the function of astrocytes in retinal health and disease. We have now established transgenic mice that overexpress the Nuc1 mutant form of Cryba1, specifically in astrocytes. Astrocytes in wild type mice show normal compact stellate structure, producing a honeycomb-like network. In contrast, in transgenics over-expressing the mutant (Nuc1) Cryba1 in astrocytes, bundle-like structures with abnormal patterns and morphology were observed. In the nerve fiber layer of the transgenic mice, an additional layer of astrocytes adjacent to the vitreous is evident. This abnormal organization of astrocytes affects both the superficial and deep retinal vascular density and remodeling. Fluorescein angiography showed increased venous dilation and tortuosity of branches in the transgenic retina, as compared to wild type. Moreover, there appear to be fewer interactions between astrocytes and endothelial cells in the transgenic retina than in normal mouse retina. Further, astrocytes overexpressing the mutant βA3/A1-crystallin migrate into the vitreous, and ensheath the hyaloid artery, in a manner similar to that seen in the Nuc1 rat. Together, these data demonstrate that developmental abnormalities of astrocytes can affect the normal remodeling process of both fetal and retinal vessels of the eye and that βA3/A1-crystallin is essential for normal astrocyte function in the retina.

Ontogeny of oxytocin and vasopressin receptor binding in the lateral septum in prairie and montane voles
Z. Wang, L.J. Young
Developmental Brain Research 1997; 104:191–195.

Adult prairie (Microtus ochrogaster). and montane voles (M. montanus). differ in the distribution of oxytocin OT. and vasopressin AVP receptor binding in the brain. The present study examined the ontogenetic pattern of these receptor bindings in the lateral septum in both species to determine whether adult differences in the receptor binding are derived from a common pattern in development. In both species, OT and AVP receptor binding in the lateral septum were detected neonatally, increased during development, and reached the adult level at weaning third week. The progression of OT and AVP receptor differed, as OT receptor binding increased continually until weaning while AVP receptor binding did not change in the first week, increased rapidly in the second week, and was sustained thereafter. For both receptors, the binding increased more rapidly in montane than in prairie voles, resulting in species differences in receptor binding at weaning and in adulthood. Together, these data indicate that OT and AVP could affect the brain during development in a peptide- and species-specific manner in voles.

Evolution of the vasopressin/oxytocin superfamily: Characterization of a cDNA encoding a vasopressin-related precursor, preproconopressin, from the mollusc Lymnaea stagnalis
RE Van Kesteren, AB Smit, RW Dirksi, ND De With, WPM Geraerts, and J Joosse
Proc. Nadl. Acad. Sci. USA May 1992; 89: 4593-4597. Neurobiology

Although the nonapeptide hormones vasopressin, oxytocin, and related peptides from vertebrates and some nonapeptides from invertebrates share similarities in amino acid sequence, their evolutionary relationships are not dear. To investigate this issue, we doned a cDNA encoding a vasopressin-related peptide, Lys-conopressin, produced in the central nervous system of the gastropod mollusc Lymnaea stagnalis. The predicted preproconopressin has the overall architecture of vertebrate preprovasopressins, with a signal peptide, Lys-conopressin, that is flanked at the C terminus by an amidation signal and a pair of basic residues, followed by a neurophysin domain. The Lymnaea neurophysin and the vertebrate neurophysins share high sequence identity, which includes the conservation of all 14 cysteine residues. In addition, the Lymnaea neurophysin possesses unique structural characteristics. It contains a putative N-linked glycosylation site at a position in the vertebrate neurophysins where a strictly conserved tyrosine residue, which plays an essential role in binding of the nonapptide hormones, is found. The C-terminal copeptin homologous extension of the Lymnaea neurophysin has low sequence identity with the vertebrate counterparts and is probably not cleaved from the prohormone, as are the mammalin copeptins. The conopressin gene is expressed in only a few neurons in both pedal ganglia of the central nervous system. The conopressin transcript is present in two sizes, due to alternative use of polyadenylylation signals. The data presented here demonstrate that the typical organization of the prohormones of the vasopressin/oxytocin superfamily must have been present in the common ancestors of vertebrates and invertebrates.

A common allele in the oxytocin receptor gene (OXTR) impacts prosocial temperament and human hypothalamic-limbic structure and function
H Tosta, B Kolachanaa, S Hakimia, H Lemaitrea, BA Verchinskia, et al.
PNAS Aug 3, 2010; 107(31): 13936–13941
http://pnas.org/cgi/doi/10.1073/pnas.1003296107

The evolutionarily highly conserved neuropeptide oxytocin is a key mediator of social and emotional behavior in mammals, including humans. A common variant (rs53576) in the oxytocin receptor gene (OXTR) has been implicated in social-behavioral phenotypes, such as maternal sensitivity and empathy, and with neuropsychiatric disorders associated with social impairment, but the intermediate neural mechanisms are unknown. Here, we used multimodal neuroimaging in a large sample of healthy human subjects to identify structural and functional alterations in OXTR risk allele carriers and their link to temperament. Activation and interregional coupling of the amygdala during the processing of emotionally salient social cues was significantly affected by genotype. In addition, evidence for structural alterations in key oxytocinergic regions emerged, particularly in the hypothalamus. These neural characteristics predicted lower levels of reward dependence, specifically in male risk allele carriers. Our findings identify sex-dependent mechanisms impacting the structure and function of hypothalamic-limbic circuits that are of potential clinical and translational significance.
Test of Association Between 10 SNPs in the Oxytocin Receptor Gene and Conduct Disorder
JT Sakai, TJ Crowley, MC Stallings, M McQueen, JK Hewitt, C Hopfer, et al.
Psychiatr Genet. 2012 Apr; 22(2): 99–102. http://dx.doi.org:/10.1097/YPG.0b013e32834c0cb2

Animal and human studies have implicated oxytocin (OXT) in affiliative and prosocial behaviors. We tested whether genetic variation in the OXT receptor (OXTR) gene is associated with conduct disorder (CD).
Utilizing a family-based sample of adolescent probands recruited from an adolescent substance abuse treatment program, control probands and their families (total sample n=1,750), we conducted three tests of association with CD and 10 SNPs (single nucleotide polymorphisms) in the OXTR gene: (1) family-based comparison utilizing the entire sample; (2) within-Whites, case control comparison of adolescent patients with CD and controls without CD; and (3) within-Whites case-control comparison of parents of patients and parents of controls.
Family-based association tests failed to show significant results (no results p<0.05). While strictly correcting for the number of tests (α=0.002), adolescent patients with CD did not differ significantly from adolescent controls in genotype frequency for the OXTR SNPs tested; similarly, comparison of OXTR genotype frequencies for parents failed to differentiate patient and control family type, except a trend association for rs237889 (p=0.004). In this sample, 10 SNPs in the OXTR gene were not significantly associated with CD.

Leu55Pro transthyretin accelerates subunit exchange and leads to rapid formation of hybrid tetramers
CA Keetch, EHC Bromley, MG McCammon, N Wang, J Christodoulou, CV Robinson
JBC  Oct 11, 2005 M508753200. http://jbc.org/cgi/doi/10.1074/jbc.M508753200

Transthyretin is a tetrameric protein associated with the commonest form of

systemic amyloid disease. Using isotopically labeled proteins and mass spectrometry we compared subunit exchange in wild-type transthyretin with that of the variant associated with the most aggressive form of the disease, Leu55Pro. Wild-type subunit exchange occurs via both monomers and dimers , while exchange via dimers is the dominant mechanism for the Leu55Pro variant. Since patients with the Leu55Pro mutation are heterozygous, expressing both proteins simultaneously, we also analyzed the subunit exchange reaction between wild-type and Leu55Pro tetramers . We found that hybrid tetramers containing two or three Leu55Pro subunits dominate in the early stages of the reaction. Surprisingly we also found that in the presence of Leu55Pro transthyretin, the rate of dissociation of wild-type transthyretin is increased. This implies interactions between the two proteins that accelerate the formation of hybrid tetramers, a result with important implications for transthyretin amyloidos is.

Beyond Genetic Factors in Familial Amyloidotic Polyneuropathy: Protein Glycation and the Loss of Fibrinogen’s Chaperone Activity
G da Costa, RA Gomes, A Guerreiro, E Mateus, E Monteiro, et al.
PLoS ONE 2011; 6(10): e24850. http://dx.doi.org:/10.1371/journal.pone.0024850

Familial amyloidotic polyneuropathy (FAP) is a systemic conformational disease characterized by extracellular amyloid fibril formation from plasma transthyretin (TTR). This is a crippling, fatal disease for which liver transplantation is the only effective therapy. More than 80 TTR point mutations are associated with amyloidotic diseases and the most widely accepted disease model relates TTR tetramer instability with TTR point mutations. However, this model fails to explain two observations. First, native TTR also forms amyloid in systemic senile amyloidosis, a geriatric disease. Second, age at disease onset varies by decades for patients bearing the same mutation and some mutation carrier individuals are asymptomatic throughout their lives. Hence, mutations only accelerate the process and non-genetic factors must play a key role in the molecular mechanisms of disease. One of these factors is protein glycation, previously associated with conformational diseases like Alzheimer’s and Parkinson’s. The glycation hypothesis in FAP is supported by our previous discovery of methylglyoxal-derived glycation of amyloid fibrils in FAP patients. Here we show that plasma proteins are differentially glycated by methylglyoxal in FAP patients and that fibrinogen is the main glycation target. Moreover, we also found that fibrinogen interacts with TTR in plasma. Fibrinogen has chaperone activity which is compromised upon glycation by methylglyoxal. Hence, we propose that methylglyoxal glycation hampers the chaperone activity of fibrinogen, rendering TTR more prone to aggregation, amyloid formation and ultimately, disease.

Aromatic Sulfonyl Fluorides Covalently Kinetically Stabilize Transthyretin to Prevent Amyloidogenesis while Affording a Fluorescent Conjugate
NP Grimster, S Connelly, A Baranczak, J Dong, …, JW Kelly
J Am Chem Soc. 2013 Apr 17; 135(15): 5656–5668. http://dx.doi.org:/10.1021/ja311729d

Molecules that bind selectively to a given protein and then undergo a rapid chemoselective reaction to form a covalent conjugate have utility in drug development. Herein a library of 1,3,4-oxadiazoles substituted at the 2 position with an aryl sulfonyl fluoride and at the 5 position with a substituted aryl known to have high affinity for the inner thyroxine binding subsite of transthyretin (TTR) were conceived of by structure-based design principles and were chemically synthesized. When bound in the thyroxine binding site, most of the aryl sulfonyl fluorides react rapidly and chemoselectively with the pKa-perturbed K15 residue, kinetically stabilizing TTR and thus preventing amyloid fibril formation, known to cause polyneuropathy. Conjugation t50s range from 1 to 4 min, ~ 1400 times faster than the hydrolysis reaction outside the thyroxine binding site. Xray crystallography confirms the anticipated binding orientation and sheds light on the sulfonyl fluoride activation leading to the sulfonamide linkage to TTR. A few of the aryl sulfonyl fluorides efficiently form conjugates with TTR in plasma. A few of the TTR covalent kinetic stabilizers synthesized exhibit fluorescence upon conjugation and therefore could have imaging applications as a consequence of the environment sensitive fluorescence of the chromophore.

Identification of S-sulfonation and S-thiolation of a novel transthyretin Phe33Cys variant from a patient diagnosed with familial transthyretin amyloidosis
A Lim, T Prokaeva, ME Mccomb, LH Connors, M Skinner, and CE Costello
Protein Science 2003; 12:1775–1786.
http://proteinscience.org/cgi/doi/10.1110/ps.0349703.

Familial transthyretin amyloidosis (ATTR) is an autosomal dominant disorder associated with a variant form of the plasma carrier protein transthyretin (TTR). Amyloid fibrils consisting of variant TTR, wild-type TTR, and TTR fragments deposit in tissues and organs. The diagnosis of ATTR relies on the identification of pathologic TTR variants in plasma of symptomatic individuals who have biopsy proven amyloid disease. Previously, we have developed a mass spectrometry-based approach, in combination with direct DNA sequence analysis, to fully identify TTR variants. Our methodology uses immunoprecipitation to isolate TTR from serum, and electrospray ionization and matrix-assisted laser desorption/ionization mass spectrometry (MS) peptide mapping to identify TTR variants and posttranslational modifications. Unambiguous identification of the amino acid substitution is performed using tandem MS (MS/MS) analysis and confirmed by direct DNA sequence analysis. The MS and MS/MS analyses also yield information about posttranslational modifications. Using this approach, we have recently identified a novel pathologic TTR variant. This variant has an amino acid substitution (Phe — Cys) at position 33. In addition, like the Cys10 present in the wild type and in this variant, the Cys33 residue was both S-sulfonated and S-thiolated (conjugated to cysteine, cysteinylglycine, and glutathione). These adducts may play a role in the TTR fibrillogenesis.

Evolutionary relationships of lactate dehydrogenases (LDHs) from mammals, birds, an amphibian, fish, barley, and bacteria: LDH cDNA sequences from Xenopus, pig, and rat
S Tsuji, MA Qureshi, EW Hou, WM Fitch, and S S.-L. Li
Proc. Natl. Acad. Sci. USA Sep 1994; 91: 9392-9396. Evolution

The nucleotide sequences of the cDNAs encoding LDH (EC 1.1.1.27) subunits LDH-A (muscle), LDH-B (liver), and LDH-C (oocyte) from Xenopus laevis, LDH-A (muscle) and LDH-B (heart) from pig, and LDH-B (heart) and LDH-C (testis) from rat were determined. These seven newly deduced amino acid sequences and 22 other published LDH sequences, and three unpublished fish LDH-A sequences kindly provided by G. N. Somero and D. A. Powers, were used to construct the most parsimonious phylogenetic tree of these 32 LDH subunits from mammals, birds, an amphibian, fish, barley, and bacteria. There have been at least six LDH gene duplications among the vertebrates. The Xenopus LDH-A, LDH-B, and LDH-C subunits are most closely related to each other and then are more closely related to vertebrate LDH-B than LDH-A. Three fish LDH-As, as well as a single LDH of lamprey, also seem to be more related to vertebrate LDH-B than to land vertebrate LDH-A. The mammalian LDH-C (testis) subunit appears to have diverged very early, prior to the divergence of vertebrate LDH-A and LDH-B subunits, as reported previously.

Evidence for neutral and selective processes in the recruitment of enzyme-crystallins in avian lenses
Graeme Wistow, Andrea Anderson, and Joram Piatigorsky
Proc. Natl. Acad. Sci. USA Aug 1990; 87: 6277-6280, Evolution

In apparent contrast to most other tissues, the ocular lenses in vertebrates show striking differences in protein composition between taxa, most notably in the recruitment of different enzymes as major structural proteins. This variability appears to be the result of at least partially neutral evolutionary processes, although there is also evidence for selective modification in molecular structure. Here we describe a bird, the chimney swift (Chaetura pelagica), that lacks δ-crystallin/ argininosuccinate lyase, usually the major crystallin of avian lenses. Clearly, δ-crystallin is not specifically required for a functionally effective avian lens. Furthermore the lens composition of the swift is more similar to that of the related hummingbirds than to that of the barn swallow (Hirundo rustica), suggesting that phylogeny is more important than environmental selection in the recruitment of crystallins. However differences in ε-crystallin/lactate dehydrogenase-B sequence between swift and hummingbird and other avian and reptilian species suggest that selective pressures may also be working at the molecular level. These differences also confirm the close relationship between swifts and hummingbirds.

Enzyme/crystallins and extremely high pyridine nucleotide levels in the eye lens.
Zigler, J. S., Jr.; Rao, P. V.
FASEB J. 1991; 3: 223-225.

Taxon-specific crystallins are proteins present in high abundance in the lens of phylogenetically restricted groups of animals. Recently it has been found that these proteins are actually enzymes which the lens has apparently adopted to serve as structural proteins. Most of these proteins have been shown to be identical to, or related to, oxidoreductases. In guinea pig lens, which contains zeta-crystallin, a protein with an NADPH dependent oxidoreductase activity, the levels of both NADPH and NADP* are extremely high and correlate with the concentration of zeta-crystallin. We report here nucleotide assays on lenses from vertebrates containing other enzyme/crystallins. In each case where the enzyme/crystallin is a pyridine nucleotide-binding protein the level of that particular nucleotide is extremely high in the lens. The presence of an enzyme/crystallin does not affect the lenticular concentrations of those nucleotides which are not specifically bound. The possibility that nucleotide binding may be a factor in the selection of some enzymes to serve as enzyme/crystallins is considered.

Comparison of stability properties of lactate dehydrogenase B4/ε-crystallin from different species
CEM Voorter, LTM Wintjes, PWH Heinstra, H Bloemendal and WW De Jong
Eur. J. Biochem. 1993; 211: 643-648

ε-Crystallin occurs as an abundant lens protein in many birds and in crocodiles and has been identified as heart-type lactate dehydrogenase (LDH-B4). Lens proteins have, due to their longevity and environmental conditions, extraordinary requirements for structural stability. To study lens protein stability, we compared various parameters of LDH-B4/ε-crystallin from lens and/or heart of duck, which has abundant amounts of this enzyme in its lenses, and of chicken and pig, which have no λ-crystallin. Measuring the thermostability of LDH-B4 from the different sources, the t50 values (temperature at which 50% of the enzyme activity remains after a 20-min period) for LDH-B4 from duck heart, duck lens and chicken heart were all found to be around 76°C whereas pig heart LDHB4 was less thermostable, having a t50 value of 625°C. A similar tendency was found with urea inactivation studies. Plotting the first-order rate constants obtained from inactivation kinetic plots against urea concentration, it was clear that LDH-B4 from pig heart was less stable in urea than the homologous enzymes from duck heart, chicken heart and duck lens. The duck and chicken enzymes were also much more resistant against proteolysis than the porcine enzyme. Therefore, it is concluded that avian LDH-B4 is structurally more stable than the homologous enzyme in mammals. This greater stability might make it suitable to function as a ε-crystallin, as in duck, but is not necessarily associated with high lens expression, as in chicken.

Duck lens ε-crystallin and lactate dehydrogenase B4 are identical: A single-copy gene product with two distinct functions
W Hendriks, JWM Mulders, MA Bibby, C Slingsby, H Bloemendal, and WW De Jong
Proc. Natl. Acad. Sci. USA Oct 1988; 85: 7114-7118. Biochemistry

To investigate whether or not duck lens ε-crystaliin and duck heart lactate dehydrogenase (LDH) B4 are the product of the same gene, we have isolated and sequenced cDNA clones of duck ε-crystallin. By using these clones we demonstrate that there is a single-copy Ldh-B gene in duck and in chicken. In the duck lens this gene is overexpressed, and its product is subject to posttranslational modification. Reconstruction of the evolutionary history of the LDH protein family reveals that the mammalian Ldh-C gene most probably originated from an ancestral Ldh-A gene and that the amino acid replacement rate in LDH-C is approximately 4 times the rate in LDH-A. Molecular modeling of LDH-B sequences shows that the increased thermostability of the avian tetramer might be explained by mutations that increase the number of ion pairs. Furthermore, the replacement of bulky side chains by glycines on the corners of the duck protein suggests an adaptation to facilitate close packing in the lens.

Lactate Dehydrogenase A as a Highly Abundant Eye Lens Protein in Platypus (Ornithorhynchus anatinus): Upsilon (υ)-Crystallin
T van Rheede,  R Amons, N Stewart, and WW de Jong
Mol. Biol. Evol. 2003; 20(06):994–998. http://dx.doi.org:/10.1093/molbev/msg116

Vertebrate eye lenses mostly contain two abundant types of proteins, the α-crystallins and the β/λ-crystallins. In addition, certain housekeeping enzymes are highly expressed as crystallins in various taxa. We now observed an unusual approximately 41-kd protein that makes up 16% to 18% of the total protein in the platypus eye lens. Its cDNA sequence was determined, which identified the protein as muscle-type lactate dehydrogenase A (LDH-A). It is the first observation of LDH-A as a crystallin, and we designate it upsilon (υ)-crystallin. Interestingly, the related heart-type LDH-B occurs as an abundant lens protein, known as ε-crystallin, in many birds and crocodiles. Thus, two members of the ldh gene family have independently been recruited as crystallins in different higher vertebrate lineages, suggesting that they are particularly suited for this purpose in terms of gene regulatory or protein structural properties. To establish whether platypus LDH-A/υ-crystallin has been under different selective constraints as compared with other vertebrate LDH-A sequences, we reconstructed the vertebrate Ldh-A gene phylogeny. No conspicuous rate deviations or amino acid replacements were observed.

Isozymes, moonlighting proteins and promiscous enzymes
M Nath Gupta, M Kapoor, AB Majumder and V Singh
Current Science Apr 2011; 100(8): 1152-1162.

The structures of isoenzymes differ and yet these catalyse the same type of reaction. These structures evolved to suit the physiological needs and are located in different parts of cells or tissues. Moonlighting proteins represent the same structure performing very different biological functions. Biological promiscuity reveals that the same active sites can catalyse different types of reactions. These three different phenomena, all illustrate similar evolutionary strategies. Viewed together, it emerges that biologists need to take a hard look at the ‘structure–function’ paradigm as well as the notions of biological specificity. Meanwhile, biotechnologists  continue to exploit the opportunities which ‘nonspecificity’ offers.

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Larry H. Bernstein, MD, FCAP, Author and Curator

Leaders in Pharmaceutical Innovation

Introduction

This contribution to a series of articles on the history of physiology, biochemistry, molecular biology, and medicine, examines several instances of conserved proteins over perhaps millions of years and across species of eukaryotes.  These findings appear to be unique in some respects within certain specific areas of scientific investigation, but while the accuracy of this observation might perhaps be open to challenge, the clarification of these observations should open up and enrich our understanding of biological function.

Conversations with Jose Eduardo des Salles Rosalino raised this question? How is it that developments late in the 20th century diverted the attention of biological processes from a dynamic construct involving interacting chemical reactions under rapidly changing external conditions effecting tissues and cell function to a rigid construct that is determined unilaterally by the genome construct, diverting attention from mechanisms essential for seeing the complete cellular construct?

He calls attention to the article titled Neo -Darwinism, The Modern Synthesis and Selfish Genes that bares no relationship with Physiology with Molecular Biology J. Physiol 2011; 589(5): 1007-11 by Denis Noble. Further, he identifies it as the key factor required in order to understand the dislodgement of physiology as the foundation of medical reasoning. This is because of the near unilateral emphasis of genomic activity as a determinant of cellular. The DNA to protein link goes from triplet sequence to amino acid sequence. That is the realm of genetics. However, protein conformation, activity and function requires that environmental and micro-environmental factors should be considered (Biochemistry). If that were not the case, we have no way to bridge the gap between the genetic code and the evolution of cells, tissues, organs, and organisms.

He continues with this example.  I would like to stress in the cAMP coupled hormonal response, the transfer of conformation from protein to protein is paramount. For instance, if your scheme goes beyond cAMP, it will show an effect over a self-assembly (inhibitor protein and protein kinase). This effect is not in any way determined by the translation of the genetic code. It is an energetic homeostatic response. Most important, sequence alone does not explain conformation, activity and function of regulatory proteins.  If this important mechanism was not ignored, the work of S Prusiner would be easily understood. For, self-assembly versus change in covalent modification of proteins (see R. A Kahn and A. G Gilman 1984 J. Biol. Chem. v. 259,n 10 pp6235-6240.) In this case, trimeric or dimeric G does not matter.” Signaling transduction tutorial”.

We know that proteins have primary, secondary, and tertiary structure. The primary structure is transcribed from the genetic code. The secondary structure constitutes the first level of protein folding. It is stabilized by strong interactions between side chains of neighboring amino acids, and it consists of the linear sequence of amino acids connected by peptide linkages. Altering a single amino acid is associated with a gene mutation, which might result in a non-functioning protein. The secondary structure  is primarily responsible for lining up the active site residues within a protein structure, and it is stabilized by a few, but very strong disulfide bonds between adjacent cysteine amino acids within the polypeptide chains.

The coiling or folding of a polypeptide chain gives the protein its 3-D shape. The alpha (α) helix structure resembles a coiled spring and is secured by hydrogen bonding in the polypeptide chain. The beta (β) pleated sheet is a structure that appears to be folded or pleated and is held together by hydrogen bonding between polypeptide units of the folded chain that lie adjacent to one another.  The 3-D structure of the polypeptide chain of a protein is determined by several types of bonds and forces that hold a protein in its tertiary structure. Hydrophobic interactions greatly contribute to the folding and shaping of a protein. The “R” group of the amino acid is either hydrophobic or hydrophilic, which in effect either causes the “R” to avoid water and pull into the center of the molecule, or alternatively, to seek contact with water.  Due to protein folding, ionic bonding can occur between the positively and negatively charged “R” groups that come in close contact with one another. Folding can also result in covalent bonding between the “R” groups of cysteine amino acids. This type of bonding forms what is called a disulfide bridge. Interactions called van der Waals forces also assist in the stabilization of protein structure. These interactions pertain to the attractive and repulsive forces that occur between molecules that become polarized. These forces contribute to the bonding that occurs between molecules.

Quaternary structure  refers to the structure of a protein macromolecule formed by interactions between multiple polypeptide chains. Each polypeptide chain is referred to as a subunit. Proteins with quaternary structure may consist of more than one of the same or different type of protein subunit. This is common for catalytical enzymes and for plasma circulating transport proteins.  It is also consequential for physiological and pathophysiological events. Typical examples are hemoglobin and transthyretin.

Self-assembly is a phenomenon where the components of a system assemble themselves spontaneously via an interaction to form a larger functional unit. This spontaneous organization can be due to direct specific interaction and/or indirectly through their environment. The spatial arrangements of these self-assembled molecules can be potentially used to build increasingly complex structures. Some properties of atoms and molecules enable them to arrange themselves into patterns.

Self-assembly is an equilibrium process where the assembled components are in equilibrium with the individual components. Self-assembly is driven by the minimization of Gibbs free energy. The minimization of Gibbs free energy is attained by the minimization of repulsive and the maximization of attractive molecular interactions. In addition, the lower free energy is usually a result of a weaker intermolecular force between self-assembled moieties and is essentially enthalpic in nature.

The thermodynamics of the self-assembly process can be represented by a simple Gibbs free energy equation:

\Delta G_{SA} = \Delta H_{SA} -T \Delta S_{SA} \,

where if \Delta G_{SA} \, is negative, self-assembly is a spontaneous process. \Delta H_{SA} \, is the enthalpy change of the process and is largely determined by the potential energy/intermolecular forces between the assembling entities. \Delta S_{SA} \, is the change in entropy associated with the formation of the ordered arrangement. In general, the organization is accompanied by a decrease in entropy and in order for the assembly to be spontaneous the enthalpy term must be negative and in excess of the entropy term. This equation shows that as the value of T \Delta S_{SA} \, approaches the value of \Delta H_{SA} \, and above a critical temperature, the self-assembly process will become progressively less likely to occur and spontaneous self-assembly will not happen.

The self-assembly is governed by the normal processes of nucleation and growth. Small assemblies are formed because of their increased lifetime as the attractive interactions between the components lower the Gibbs free energy. As the assembly grows, the Gibbs free energy continues to decrease until the assembly becomes stable enough to last for a long period of time. The necessity of the self-assembly to be an equilibrium process is defined by the organization of the structure which requires non-ideal arrangements to be formed before the lowest energy configuration is found.

Intermolecular forces govern the particle interaction in self-assembled systems. The forces tend to be intermolecular in type rather than ionic or covalent because ionic or covalent bonds will “lock” the assembly into non-equilibrium structures. The types intermolecular forces seen in self-assembly processes are van der Waals, hydrogen bonds, and weak polar forces, just to name a few. In self-assembly, regular structural arrangements are frequently observed, therefore there must be a balance of attractive and repulsive between molecules otherwise an equilibrium distance will not exist between the particles. The repulsive forces can be electron cloud-electron cloud overlap or electrostatic repulsion.  (Wikipedia)

This description fits nicely into the intermolecular interactions between protein polypeptides in both tertiary and  quaternary structure. This principle is being utilized in the engineering of nanoparticles that will self-assemble for one or both of two reasons: molecular interactions and external direction. The assembly of nanoparticles of two different materials into a binary nanoparticle superlattice is a promising way of synthesizing a large variety of materials

Prions , Stanley B. Prusiner (PNAS 1998, Nov 10;  95(23):    13363–13383, http://dx.doi.org:/10.1073/pnas.95.23.13363

Prion diseases may present as genetic, infectious, or sporadic disorders, all of which involve modification of the prion protein (PrP). Prions are transmissible particles that are devoid of nucleic acid and seem to be composed exclusively of a modified protein (PrPSc). The normal, cellular PrP (PrPC) is converted into PrPSc through a posttranslational process during which it acquires a high β-sheet content. The species of a particular prion is encoded by the sequence of the chromosomal PrP gene of the mammals in which it last replicated. In contrast to pathogens carrying a nucleic acid genome, prions appear to encipher strain-specific properties in the tertiary structure of PrPSc. Transgenetic studies argue that PrPSc acts as a template upon which PrPC is refolded into a nascent PrPSc molecule through a process facilitated by another protein.

Miniprions generated in transgenic mice expressing PrP, in which nearly half of the residues were deleted, exhibit unique biological properties and should facilitate structural studies of PrPSc. Knowledge about prions has profound implications for studies of the structural plasticity of proteins.

Prusiner relates:

Libyan Jews living in Israel developed CJD about 30 times more frequently than other Israelis. This finding prompted some investigators to propose that the Libyan Jews had contracted CJD by eating lightly cooked brain from scrapie-infected sheep when they lived in Tripoli prior to emigration. Subsequently, the Libyan Jewish patients were all found to carry a mutation at codon 200 in their prion protein (PrP) gene.

I was beginning a residency in neurology in 1972 and was most impressed by a disease process that could kill my patient in 2 months by destroying her brain while her body remained unaffected by this process. No febrile response, no leukocytosis or pleocytosis, no humoral immune response, and yet I was told that she was infected with a “slow virus.” In scrapie, kuru, CJD, and all of the other disorders now referred to as prion diseases, spongiform degeneration and astrocytic gliosis is found upon microscopic examination of the CNS. The extent of reactive gliosis correlates with the degree of neuron loss.

neuropathologic changes with RML scrapie prions

neuropathologic changes with RML scrapie prions

Neuropathologic changes in Swiss mice after inoculation with RML scrapie prions.

In view of daunting logistical problems, the identification of an inoculum that produced scrapie in the golden Syrian hamster (SHa) in ≈70 days after intracerebral inoculation proved to be an important advance once an incubation time assay was developed.  It provided a means to assess quantitatively those fractions that were enriched for infectivity and those that were not. A protocol was developed for separating scrapie infectivity from most proteins and nucleic acids. With a ≈100-fold purification of infectivity relative to protein, >98% of the proteins and polynucleotides were eliminated, permitting more reliable probing of the constituents of these enriched fractions.

A particular macromolecule was required for infectivity and this macromolecule was a protein. The experimental findings extended earlier observations on resistance of scrapie infectivity to UV irradiation at 250 nm in that the four different procedures used to probe for a nucleic acid are based on physical principles that are independent of UV radiation damage. I defined prions as proteinaceous infectious particles that resist inactivation by procedures that modify nucleic acids.The best current working definition of a prion is a proteinaceous infectious particle that lacks nucleic acid, because a wealth of data supports the contention that scrapie prions are composed entirely of a protein that adopts an abnormal conformation. From a broader perspective, prions are elements that impart and propagate conformational variability.

JEDS continues with his observations about the uniqueness of the functional understanding of proteins. He refers to lessons derived from discussions with Leloir, and an imaginary dissertation by Schrodinger to Darlington and Haldane, the two distinguished biologists of their time.  His vision was that that biochemistry could provide two legs to support the advance of biology and medicine (one leg was for normal physiology and the other the solitary leg of molecular biology, for genetics). This view includes a chemical reactivity scenario that in Leloir´s vision on the subject, he considers to be of paramount importance. A chemical reaction point of view prevents any scientific supporting leg to be placed in an opposite   or wrong position as it is in the simple statement that ALL information in life moves from DNA, through RNA and to proteins.

Complex life forms have followed what we usually understand as evolution, variation and selection leading to new forms of life and old ones being extinct without a direct selective pressure upon its amount of DNA.  For the more complex life forms, neutral mutations would be very important in the evolution process than for bacteria. However, it also, may shed some new light upon the controversy of a small step in evolution as Charles Darwin proposed, and in addition, some more modern views that have indicated that abrupt changes might have occurred during the biological time line. Neutral evolution might have happened as small step evolution, as imagined by Darwin.  Only after a rather long period of time, and after a large series of neutral mutations, a new function, or a new phenotype appears after a last small step, the last neutral mutation.

A set of genes from both parents seems to be closer to the common ancestry of both parents than to either parent. These ancestral genes that are present may be expressed in complex living beings, are no longer present in modern microorganisms genomes as well as previous non-coding DNA. This last aspect of the genome makes clear the difference in evolution pathways of microorganisms in comparison with more complex forms of life.

Crystallins of the eye lens, cornea, and retina

Regulation of gene expression by Pax6 in ocular cells: a case of tissue-preferred expression of crystallins in lens
A Cvekl, Y Yang, BK Chauhan and K Cveklova
Int. J. Dev. Biol. 2004; 48: 829-844.  http://dx.doi.org:/10.1387/ijdb.041866ac

Lens development is an excellent model for genetic and biochemical studies of embryonic induction, cell cycle regulation, cellular differentiation and signal transduction. Differentiation of lens is characterized by lens-preferred expression and accumulation of water-soluble proteins, crystallins. Crystallins are required for light transparency, refraction and maintenance of lens integrity. Here, we review mechanisms of lens-preferred expression of crystallin genes by employing synergism between developmentally regulated DNA-binding transcription factors: Pax6, c-Maf, MafA/L-Maf, MafB, NRL, Sox2, Sox1, RARβ/RXRβ, RORα, Prox1, Six3, γFBP-B and HSF2. These factors are differentially expressed in lens precursor cells, lens epithelium and primary and secondary lens fibers. They exert their function in combination with ubiquitously expressed factors (e.g. AP-1, CREB, pRb, TFIID and USF) and co-activators/chromatin remodeling proteins (e.g. ASC-2 and CBP/p300). A special function belongs to Pax6, a paired domain and homeodomain-containing protein, which is essential for lens formation. Pax6 is expressed in lens progenitor cells before the onset of crystallin expression and it serves as an important regulatory factor required for expression of c-Maf, MafA/L-Maf, Six3, Prox1 and retinoic acid signaling both in lens precursor cells and the developing lens. The roles of these factors are illustrated by promoter studies of mouse αA-, αB-, γF- and guinea pig ζ-crystallins. Pax6 forms functional complexes with a number of transcription factors including the retinoblastoma protein, pRb, MafA, Mitf and Sox2. We present novel data showing that pRb antagonizes Pax6-mediated activation of the αA-crystallin promoter likely by inhibiting binding of Pax6 to DNA.

The transcription factor D-Pax2 regulates Crystallin production during eye development in Drosophila melanogaster
K Dziedzic, J Heaphy, H Prescott, and J Kavaler
Dev Dyn. 2009 Oct; 238(10): 2530–2539. http://dx.doi.org:/10.1002/dvdy.22082

The generation of a functioning Drosophila eye requires the coordinated differentiation of multiple cell types and the morphogenesis of eye-specific structures. Here we show that D-Pax2 plays a significant role in lens development through regulation of the Crystallin gene and that Crystallin is also expressed in D-Pax2+ cells in the external sensory organs. Loss of D-Pax2 function leads to loss of Crystallin expression in both eyes and bristles. A 2.3 kilobase upstream region of the Crystallin gene can drive GFP expression in the eye and is dependent on D-Pax2. In addition, D-Pax2 binds to an evolutionarily conserved site in this region which, by itself, is sufficient to drive GFP expression in the eye. However, mutation of this site does not greatly affect the regulatory region’s function. The data indicate that D-Pax2 acts to promote lens development by controlling the production of the major protein component of the lens. Whether this control is direct or indirect remains unresolved.

Cubozoan jellyfish: an Evo/Devo model for eyes and other sensory systems
J PIATIGORSKY, and Z KOZMIK
Int. J. Dev. Biol. 2004; 48: 719-729. http://dx.doi.org:/10.1387/ijdb.041851jp

Cnidaria are the most basal phylum containing a well-developed visual system located on specialized sensory structures (rhopalia) with eyes and statocyts. We have been exploring the cubozoan jellyfish, Tripedalia cystophora. In addition to containing simple photoreceptive ocelli, each rhopalium in Tridedalia has a large and small complex, camera-type eye with a cellular lens containing three distinct families of crystallins which apparently serve non-lenticular functions. Thus, Tridpedalia recruited crystallins by a gene sharing strategy as have mollusks and vertebrates. Tripedalia has a single Pax gene, PaxB, which encodes a structural and functional Pax 2/5/8-like paired domain as well as an octapeptide and Pax6-like homeodomain. PaxB binds to and activates Tripedalia crystallin promoters (especially J3-crystallin) and the Drosophila rhodopsin rh6 gene in transfection tests and induces ectopic eyes in Drosophila. In situ hybridization showed that PaxB and crystallin genes are expressed in the lens, retina and statocysts. We suggest from these results that an ancestral PaxB gene was a primordial gene in eye evolution and that eyes and ears (mechanoreceptors) may have had a common evolutionary origin. Thus, the numerous structural and molecular features of Tridpalia rhopalia indicate that ancient cubozoan jellyfish are fascinating models for evo/devo insights into eyes and other sensory systems.

aB-crystallin, a low-molecular-weight heat shock protein, acts as a regulator of platelet function
O. Kozawa, H. Matsuno, M. Niwa, D. Hatakeyama, K. Kato, and T. Uematsu
Cell Stress & Chaperones 2001; 6 (1): 21–28

It has recently been reported that aB-crystallin, a low-molecular-weight heat shock protein, may be released from cells by mechanical stretch. We investigated a physiological role of aB-crystallin in platelet function. aB-crystallin inhibited platelet aggregation induced by thrombin or botrocetin in hamsters and humans. These platelets had specific binding sites for aB-crystallin. Moreover, aB-crystallin significantly reduced thrombin-induced Ca21 influx and phosphoinositide hydrolysis by phospholipase C in human platelets. Additionally, plasma levels of aB-crystallin were markedly elevated in cardiomyopathic hamsters. Levels of aB-crystallin in vessel walls after endothelial injury were markedly reduced. Therefore, our results suggest that aB-crystallin, which is discharged from vessel walls in response to endothelial injury, acts intercellularly as a regulator of platelet function.

The role of Eph receptors in lens function and disease
AI SON, JE PARK, and RP ZHOU
Sci China Life Sci. 2012 May ; 55(5): 434–443.
http://dx.doi.org:/10.1007/s11427-012-4318-7.

In recent years the Eph family of receptor tyrosine kinases has been identified as a key regulator in lens clarity. In this review we discuss the roles of the Eph receptors in lens biology and cataract development.

As the primary role of the lens is to provide proper light refraction to the retina, the organ must possess several inherent characteristics, including stability, clarity, and the proper refractive index, to function appropriately. This is made possible in part through key features of the cytoplasmic content of lens fiber cells. One particularly unique aspect of lens fiber cells is their absence of organelles. Occurring during the later aspects of the differentiation process, fiber cells experience a gradual degradation of nuclei and organelles over a span of several days in what has been described as an “attenuated apoptosis”. This event is crucial for maintaining lens transparency as the absence of internal cellular structures allows light to travel unimpeded through the structure to the retina.

In addition to the loss of organelles, fiber cells achieve their appropriate refractive properties through regulation of their protein content. The bulk of the lens consists of soluble proteins known as the crystallins, a family comprising of α-, β-, and γ-crystallins. Crystallins represent 90% of the protein in the lens and provide the proper refractive medium for light passage within the lens. In addition to structural functions, α-crystallin is capable of chaperone activity, preventing aggregation of proteins denatured by various stressors. This chaperone activity is particularly important in the prevention of protein aggregation that may otherwise lead to insolubility and result in cataract formation. α-crystallins are expressed in both the lens epithelium and fiber cells, while β- and γ-crystallins are exclusively in differentiated lens fiber cells and are indicators of lens cell differentiation.

Lens clarity depends on the proper regulation of several critical features including structural integrity, cellular adhesion and packing, protein stability, cell-cell communication, and circulation. Mutations in the Eph receptor EPHA2 have been recently shown to cause cataracts in humans. The loss of functions of Eph receptors may affect one or several of these processes resulting in cataractogenesis.

The protein structure is highly conserved between both the EphA and EphB subgroups. The extracellular portion of the receptors contains an ephrin ligand-binding domain at the N-terminus, followed by a cystein-rich region epidermal growth factor (EGF) repeat motif and two fibronectin type-III repeats. The intercellular portion contains the signaling components which include a juxtamembrane region, a tyrosine kinase domain, a sterile alpha motif (SAM), and a PDZ binding domain at the end of the C-terminus.

Thus far, only EphA2 and ephrin-A5 have been found to have major roles in lens development and function. Expression of EphA2 in the lens has been reported to be within the fiber layer, most notably within the subcortical region, with some expression in epithelial cell layers. Ephrin-A5 has similar localizations, with expression observed in the subcortical fiber layer as well as within the lens epithelial layer. In the mature lens, both EphA2 and ephrin-A5 expression has been observed in the short edges of lens fiber cells when lenses are oriented in cross-section.

,u-Crystallin is a mammalian homologue of Agrobacterium ornithine cyclodeaminase and is expressed in human retina
RY Kim, R Gassert, and GJ Wistow
Proc. Natl. Acad. Sci. USA 1992 Oct; 89:  9292-9296. Evolution.

µ-Crystallin is the major component of the eye lens in several Australian marsupials. The complete sequence of kangaroo -crystalln has now been obtained by cDNA cloning. The predicted amino acid sequence shows similarity with ornithine  cyclodeaminases encoded by the tumor-inducing (Ti) plasmids of Agrobacterium tumefaciens. Until now, neither ornithine cyclodeaminase nor any structurally related enzymes have been observed in eukaryotes. RNA analysis of kangaroo tissues shows that µ-crystallin is expressed at high abundance in lens, but outside the lens µ-crystallin is preferentially expressed in neural tissues, retina, and brain. An

almost full-length cDNA for µ-crystallin was cloned from human retina. In human tissues, µ-crystallin mRNA is present in neural tissue, muscle, and kidney. This pattern of expression and relationship to an enzyme involved in unusual amino acid metabolism suggests the interesting possibility that mammalian µ-crystallins could be enzymes participating in processes such as osmoregulation or the metabolism of excitatory amino acids.

Ocular Aldehyde Dehydrogenases: Protection against Ultraviolet Damage and Maintenance of Transparency for Vision
Y Chen, DC Thompson, V Koppaka, JV Jester, and V Vasiliou
Prog Retin Eye Res. 2013 Mar; 33: 28–39.
http://dx.doi.org:/10.1016/j.preteyeres.2012.10.001

Aldehyde dehydrogenase (ALDH) enzymes catalyze the NAD(P)+-dependent oxidation of a wide variety of endogenous and exogenous aldehydes to their corresponding acids. Some members of the ALDH superfamily of enzymes are abundantly expressed in the mammalian cornea and lens in a taxon-specific manner. Considered to be corneal and lens crystallins, they confer protective and transparent properties upon these ocular tissues. ALDH3A1 is highly expressed in the cornea of most mammals, with the exception of rabbit that expresses exclusively ALDH1A1 in the cornea. ALDH1A1 is present in both the cornea and lens of several animal species. As a result of their catalytic and non-catalytic functions, ALDH3A1 and ALDH1A1 proteins protect inner ocular tissues from ultraviolet radiation and reactive oxygen-induced damage. In addition, these corneal crystallins contribute to cellular transparency in corneal stromal keratocytes, supporting a structural role of these ALDH proteins. A putative regulatory function of ALDH3A1 on corneal cell proliferation has also been proposed. Finally, the three retinaldehye dehydrogenases cooperatively mediate retinoic acid signaling during the eye development.

Transthyretin

Protein aggregation: Mechanisms and functional consequences
G Invernizzi, E Papaleo, R Sabate, S Ventura
Int J Biochem & Cell Biol Sep 2012; 44(9): 1541-1554

Understanding the mechanisms underlying protein misfolding and aggregation has become a central issue in biology and medicine. Compelling evidence show that the formation of amyloid aggregates has a negative impact in cell function and is behind the most prevalent human degenerative disorders, including Alzheimer’s Parkinson’s and Huntington’s diseases or type 2 diabetes. Surprisingly, the same type of macromolecular assembly is used for specialized functions by different organisms, from bacteria to human. Here we address the conformational properties of these aggregates, their formation pathways, their role in human diseases, their functional properties and how bioinformatics tools might be of help to study these protein assemblies.

Protein aggregation simulations

Protein aggregation simulations

The most employed three-dimensional representation for in silico studies of protein aggregation. (A) All-atom explicit solvent representation adopted in classical MD simulations. Transthyretin (TTR) is shown as an example in its dimeric form (pdb entry 1F41). The solvent molecule, Na+ and Cl− ions are shown as red sticks, blue and light blue spheres, respectively. The two polypeptide chains of TTR are shown as green and cyan cartoon, respectively. (B) Coarse grained model of TTR. In coarse grained calculations, the protein residues are represented by different pseudoatoms (beads) which should capture the essential properties of each residue side-chain.

http://www.sciencedirect.com/science/article/pii/S1357272512001896#fig0010  http://ars.els-cdn.com/content/image/1-s2.0-S1357272512001896-gr2.sml

Signaling by vitamin A and retinol-binding protein in regulation of insulin responses and lipid homeostasis
Daniel C. Berry, Noa Noy
Biochim Biophys Acta (BBA) – Molec Cell Biol of Lipids, Jan 2012; 1821(1): 168-176

► Holo-RBP, which transports vitamin A in blood, is a signaling molecule. ► STRA6 functions both as a vitamin A transporter and as a surface signaling receptor activated by holo-RBP. ► Activation of STRA6 by RBP–ROH triggers a JAK/STAT cascade, thereby inducing gene trascription. ► Some genes induced by RBP–ROH/STRA6/JAK/STAT signaling are involved in regulating insulin responses and lipid metabolism.

Binding of RBP–ROH to STRA6 induces the phosphorylation of a tyrosine residue in the receptor C-terminus, thereby activating a JAK/STAT signaling cascade. Consequently, in STRA6-expressing cells such as adipocytes, RBP–ROH induces the expression of STAT target genes, including SOCS3, which suppresses insulin signaling, and PPARγ, which enhances lipid accumulation. RBP–retinol thus joins the myriad of cytokines, growth factors and hormones which regulate gene transcription by activating cell surface receptors that signal through activation of Janus kinases and their associated transcription factors STATs.

STRA6 transduces RBP–retinol signaling to trigger a JAK.STAT cascade that regulates insulin responses and lipid homeostasis

STRA6 transduces RBP–retinol signaling to trigger a JAK.STAT cascade that regulates insulin responses and lipid homeostasis

STRA6 transduces RBP–retinol signaling to trigger a JAK/STAT cascade that regulates insulin responses and lipid homeostasis
http://ars.els-cdn.com/content/image/1-s2.0-S1388198111001211-gr1.sml

The three dimensional crystal structure of holo-retinol binding protein (RBP–ROH)

The three dimensional crystal structure of holo-retinol binding protein (RBP–ROH)

Residues that stabilize the interactions of RBP with TTR are highlighted in blue. The location of these residues emphasize that interactions of RBP with TTR block the entrance to the RBP ligand-binding pocket.
http://ars.els-cdn.com/content/image/1-s2.0-S1388198111001211-gr2.sml

The three dimensional crystal structure of the retinol–RBP–TTR complex. Human retinol–RBP–TTR [29] (PDB ID:1QAB) was generated using Pymol (http://www.pymol.org/). The TTR tetramer (magenta) is comprised of a dimer of dimers with two RBP molecules (red) bound to the opposite dimers. Interactions between RBP and TTR are mediated by residues at the entrance to the ligand binding pocket and span across the two TTR dimers.
http://ars.els-cdn.com/content/image/1-s2.0-S1388198111001211-gr3.sml
http://www.sciencedirect.com/science/article/pii/S1388198111001211#f0015

Fourier Transform Infrared Spectroscopy Provides a Fingerprint for the Tetramer and for the Aggregates of Transthyretin
Y Cordeiro, J Kraineva, MC Suarez, AG Tempesta, JW Kelly, JL Silva, et al.
Biophys J, 1 Aug 2006; 91(3): 957-967
Transthyretin (TTR) is an amyloidogenic protein whose aggregation is responsible for several familial amyloid diseases. Here, we use FTIR to describe the secondary structural changes that take place when wt TTR undergoes heat- or high-pressure-induced denaturation, as well as fibril formation. Upon thermal denaturation, TTR loses part of its intramolecular β-sheet structure followed by an increase in nonnative, probably antiparallel β-sheet contacts (bands at 1616 and 1686 cm−1) and in the light scattering, suggesting its aggregation. Pressure-induced denaturation studies show that even at very elevated pressures (12 kbar), TTR loses only part of its β-sheet structure, suggesting that pressure leads to a partially unfolded species. On comparing the FTIR spectrum of the TTR amyloid fibril produced at atmospheric pressure upon acidification (pH 4.4) with the one presented by the native tetramer, we find that the content of β-sheets does not change much upon fibrillization; however, the alignment of β-sheets is altered, resulting in the formation of distinct β-sheet contacts (band at 1625 cm−1). The random-coil content also decreases in going from tetramers to fibrils. This means that, although part of the tertiary- and secondary-structure content of the TTR monomers has to be lost before fibril formation, as previously suggested, there must be a subsequent reorganization of part of the random-coil structure into a well-organized structure compatible with the amyloid fibril, as well as a readjustment of the alignment of the β-sheets. Interestingly, the infrared spectrum of the protein recovered from a cycle of compression-decompression at pD 5, 37°C, is quite similar to that of fibrils produced at atmospheric pressure (pH 4.4), which suggests that high hydrostatic pressure converts the tetramers of TTR into an amyloidogenic conformation.

Multiple hepatocyte-enriched nuclear factors function in the regulation of transthyretin and alpha 1-antitrypsin genes
R H Costa, D R Grayson and J E Darnell Jr
PNAS Jun 1, 1988;  85(11): 3840-3844

Double-stranded oligodeoxynucleotides that represent protein binding sites in the regulatory regions of the mouse genes encoding transthyretin (TTR) and alpha 1-antitrypsin (alpha 1-AT) bound a nuclear protein factor(s) found mainly in hepatocytes. A site in the regulatory region of the gene encoding rat serum albumin and, surprisingly, a region in the simian virus 40 enhancer also bind the same factor. Oligodeoxynucleotide affinity chromatography (with one of the TTR binding sites) allowed a 500-fold purification of the protein. The purified protein protected similar portions of all the regulatory regions, as well as the simian virus 40 core C enhancer element, from digestion with DNase I. A DNA-binding protein previously purified from liver by virtue of its ability to bind to several virus enhancer sequences also binds to TTR, alpha 1-AT, and albumin regulatory sites. Thus, all these binding sites, which contain only minimal sequence similarity, may bind to a single protein, or a similar family of proteins, that activates liver-specific transcription of coordinately expressed genes.

Retinal Anatomy and Function of the Transthyretin Null Mouse
BV Buia, JA Armitagea, EL Fletchera, SJ Richardsonb, G Schreiberb and AJ Vingrysa.  Exp. Eye Res. 2001; 73: 651-659

TTR null mice show no anomalies of receptoral (P3) nor post-receptoral (b-wave) ERG components compared with wild-type mice. although circulating plasma levels of retinol and retinol binding protein (RBP) are extremely low, this reduction has little effect on the retinal structure or function of the TTR null mouse. These data are consistent with the existence of mechanisms for the transport of retinol to the retina independent of the classical retinol-RBP-TTR complex.

Post-translational modifications of transthyretin affect the triiodonine-binding potential
A Henze, T Homann, M Serteser, O Can, O Sezgin, et al.
J. Cell. Mol. Med. 2014; XX(X): 1-12

This study provides evidence that oxidative modifications of Cys10 seem to affect binding of T3 to TTR probably because of the introduction of a sterical hindrance and induction of conformational changes. As oxidative modifications can be dynamically regulated, this may represent a sensitive mechanism to adjust thyroid hormone availability.

Plasma and cellular retinoid-binding proteins and transthyretin are all localized in the islets of Langerhans in the rat
M Kato, K Kato, WS Blaner, BS Chertow, and DS Goodman
Proc. Nati. Acad. Sci. 1985; 82: 2488-2492

Unusually high levels of CRBP, RBP, TTR, and cellular retinoic acid BP were found in rat islets. The findings suggest that retinoids and their binding proteins may play important metabolic roles within islet cells, and hence that they may be involved in some way in the biological, endocrine function of the islets.

Potent Kinetic Stabilizers that Prevent Transthyretin-mediated Cardiomyocyte Proteotoxicity
MM Alhamadsheh, S Connelly, A Cho, N Reixach,..JW Kelly, and IA Graef
Sci Transl Med. 2011 Aug 24; 3(97): 97ra81.
http://dx.doi.org:/10.1126/scitranslmed.3002473

The V122I mutation that alters the stability of transthyretin (TTR) affects 3–4% of African Americans and leads to amyloidogenesis and development of cardiomyopathy. In addition, 10–15% of individuals over the age of 65 develop senile systemic amyloidosis (SSA) and cardiac TTR deposits due to wild-type TTR amyloidogenesis.  We developed a fluorescence polarization-based HTS screen, which identified several new chemical scaffolds targeting TTR. These novel compounds were potent kinetic stabilizers of TTR and prevented tetramer dissociation, unfolding and aggregation of both wild type and the most common cardiomyopathy-associated TTR mutant, V122I-TTR. These compounds effectively inhibited the proteotoxicity of V122I-TTR towards human cardiomyocytes.

Retinoid receptors, transporters, and metabolizers as therapeutic targets in late onset Alzheimer disease
Ann B. Goodman
J. Cell. Physiol., Dec 2006; 209: 598–603. http://dx.doi.org:/10.1002/jcp.20784

Vitamin A (retinoid) is required in the adult brain to enable cognition, learning, and memory. While brain levels of retinoid diminish over the course of normal ageing, retinoid deficit is greater in late onset Alzheimer disease (LOAD) brains than in normal-aged controls. This paper reviews recent evidence supporting these statements and further suggests that genes necessary for the synthesis, transport and function of retinoid to and within the ageing brain are appropriate targets for treatment of LOAD. These genes tend to be clustered with genes that have been proposed as candidates in LOAD, are found at chromosomal regions linked to LOAD, and suggest the possibility of an overall coordinated regulation. This phenomenon is termed Chromeron and is analogous to the operon mechanism observed in prokaryotes. Suggested treatment targets are the retinoic-acid inactivating enzymes (CYP26)s, the retinol binding and transport proteins, retinol-binding protein (RBP)4 and transthyretin (TTR), and the retinoid receptors. TTR as a LOAD target is the subject of active investigation. The retinoid receptors and the retinoid-inactivating enzymes have previously been proposed as targets. This is the first report to suggest that RBP4 is an amenable treatment target in LOAD. RBP4 is elevated in type-2 diabetes and obesity, conditions associated with increased risk for LOAD. Fenretinide, a novel synthetic retinoic acid (RA) analog lowers RBP4 in glucose intolerant obese mice. The feasibility of using fenretinide either as an adjunct to present LOAD therapies, or on its own as an early prevention strategy should be determined.

Transthyretin: a key gene involved in the maintenance of memory capacities during aging.
Brouillette J1, Quirion R.
Neurobiol Aging. 2008 Nov; 29(11): 1721-32. Epub 2007 May 23.

Aging is often associated with decline of memory function. Aged animals, like humans, can naturally develop memory impairments and thus represent a useful model to investigate genes involved in long-term memory formation that are differentially expressed between aged memory-impaired (AI) and aged memory-unimpaired (AU) animals following stimulation in a spatial memory task. We found that alterations in hippocampal gene expression of transthyretin (TTR), calcineurin, and NAD(P)H dehydrogenase quinone 2 (NQO2) were associated with memory deficits in aged animals. Decreased TTR gene expression could be attributed at least partially to diminish activity of C/EBP immediate-early gene cascade initiated by CREB since protein levels of C/EBP, a transcription factor regulating both TTR and NQO2 expression, was decreased in AI animals. Memory deficits were also found during aging in mice lacking TTR. Treatment with retinoic acid reversed cognitive deficits in these knock-out mice as well as in aged rats. Our study provides genetic, behavioural and molecular evidence that TTR is involved in the maintenance of normal cognitive processes during aging by acting on the retinoid signaling pathway.

Neuroprotective effects of natural products: interaction with intracellular kinases, amyloid peptides and a possible role for transthyretin.
Bastianetto S1, Brouillette J, Quirion R.
Neurochem Res. 2007 Oct;32(10):1720-5. Epub 2007 Apr 4.

Various studies reported on the neuroprotective effects of natural products, particularly polyphenols, widely present in food and beverages. For example, we have shown that resveratrol, a polyphenol contained present in red wine and other foods, activates the phosphorylation of protein kinase C (PKC), this effect being involved in its neuroprotective action against Ass-induced toxicity. Moreover, tea-derived catechin gallate esters inhibit the formation Ass oligomers/fibrils, suggesting that this action likely contributes to their neuroprotective effects. Interestingly, the effects of polyphenols may be attributable, at least in part, to the presence of specific binding sites. Autoradiographic studies revealed that these binding sites are particularly enriched in choroids plexus in the rat brain. Interestingly, the choroid plexus secretes transthyretin, a protein that has been shown to prevent Abeta aggregation and that may be critical to the maintenance of normal learning capacities in aging. Taken together, these data suggest that polyphenols target multiple enzymes/proteins leading to their neuroprotective actions.

Aboard Transthyretin: From Transport to Cleavage
MA Liz, FM Mar, F Franquinho and MM Sousa
IUBMB Life 2010; 62(6): 429–435.

Transthyretin (TTR) is a plasma and cerebrospinal fluid protein mainly recognized as the transporter of thyroxine (T4) and retinol. Mutated TTR leads to familial amyloid polyneuropathy, a neurodegenerative disorder characterized by TTR amyloid deposition particularly in peripheral nerves. Beside its transport activities, TTR is a cryptic protease and participates in the biology of the nervous system. Several studies have been directed at finding new ligands of TTR to further explore the biology of the protein. From the identified ligands, some were in fact TTR protease substrates. In this review, we will discuss the existent information concerning TTR ligands/substrates.

The amyloidogenic potential of transthyretin variants correlates with their tendency to aggregate in solution
A Quintasa, MJM Saraiva, RMM Brito
FEBS Letters  1997; 418: 297-300

Amyloid fibril formation and deposition are the basis for a wide range of diseases, including spongiform encephalopathies, Alzheimer’s and familial amyloidotic polyneuropathies. However, the molecular mechanisms of amyloid formation are still poorly characterized. In certain forms of familial amyloidotic polyneuropathy (FAP), the amyloid fibrils are mostly constituted by variants of transthyretin (TTR). V30M-TTR is the most frequent variant, and L55P-TTR is the variant associated with the most aggressive form of amyloidosis. Here, we report gel filtration chromatography experiments to characterize the aggregation states of WT-, V30M-, L55P-TTR and a non-amyloidogenic variant, T119M-TTR, in solution, at nearly physiological pH. These studies show that all four protein tetramers dissociate to monomer upon dilution, in the submicromolar range, at pH 7.0. The amyloidogenic proteins V30M- and L55P-TTR show a complex equilibrium between monomers, tetramers and high molecular weight aggregate species. These aggregates dissociate directly to monomer upon dilution. This study shows that the tendency to form aggregates among the four studied proteins correlates with their known amyloidogenic potential. Thus, the amyloidogenic mutations could perturb the structure and/or stability of the monomeric species leading initially to the formation of soluble aggregates and at a later stage to insoluble amyloid fibrils.

Plasma Transthyretin Indicates the Direction of both Nitrogen Balance and Retinoid Status in Health and Disease
Ingenbleek Y and Bienvenu J
The Open Clinical Chemistry Journal, 2008; 1: 1-12

Whatever the nutritional status and the disease condition, the actual transthyretin (TTR) plasma level is determined by opposing influences between anabolic and catabolic alterations. Rising TTR values indicate that synthetic processes prevail over tissue breakdown with a nitrogen balance (NB) turning positive as a result of efficient nutritional support and / or anti-inflammatory therapy. Declining TTR values point to the failure to sustain NB as an effect of maladjusted dietetic management and / or further worsening of the morbid condition. Serial measurement of TTR thus appears as a dynamic index defining the direction of NB in acute and chronic disorders. The level of TTR production by the liver also works as a limiting factor for the cellular bioavailability of retinol and retinoid derivatives which play major roles in the brain ageing process. Optimal protein nutritional status, as assessed by TTR values within the normal range, prevents the occurrence of vascular and cerebral damages while maintaining the retinoid-mediated memory, cognitive and behavioral activities of elderly persons.

In Vitro and In Vivo Interactions of Homocysteine with Human Plasma Transthyretin
A Lim, S Sengupta, ME McComb, R Théberge, WG Wilson, CE Costello, DW Jacobsen
J. Biol. Chem. Sep 24, 2003. Manuscript M306748200 http://dx.doi.org:/10.1074/jbc.M306748200

Hyperhomocysteinemia is an independent risk factor for cardiovascular disease and an emerging risk factor for cognitive dysfunction and Alzheimer’s disease. Greater than 70% of the homocysteine in plasma is disulfide bonded to protein cysteine residues. The identity and functional consequences of protein homocysteinylation are just now emerging. The amyloidogenic protein transthyretin (prealbumin), as we now report, undergoes homocysteinylation at its single cysteine residue (Cys10) both in vitro and in vivo. Thus, when human plasma or highly purified transthyretin was incubated with 35SLhomocysteine followed by SDSPAGE and phosphor-imaging, two bands corresponding to transthyretin dimer and tetramer were observed. Treatment of the labeled samples with βmercaptoethanol prior to SDSPAGE removed the disulfide bound homocysteine. Transthyretin-Cys10SS-homocysteine

was then identified in vivo in plasma from normal donors, patients with end stage renal disease and homocystinurics by immune-precipitation and HPLC/electrospray mass spectrometry. The ratios of transthyretin-Cys10SS-homocysteine and transthyretin-Cys10SS-sulfonate to that of unmodified transthyretin increased with increasing homocysteine plasma concentrations whereas the ratio of transthyretin-Cys10SS-cysteine to that of unmodified transthyretin decreased. Hyperhomocystein-emic burden is thus reflected in the plasma levels of transthyretin-Cys10SS-homocysteine, which in turn may contribute to the pathological consequences of amyloid disease.

Support for the multigenic hypothesis of amyloidosis: The binding stoichiometry of retinol-binding protein, vitamin A, and thyroid hormone influences transthyretin amyloidogenicity in vitro
Joleen T. White and Jeffery W. Kelly
PNAS  Nov 6, 2001; 98(23): 13019–13024 http://pnas/cgi/dx.doi.org:/10.1073/pnas.241406698

The amyloidoses are a large group of protein misfolding diseases.

Genetic and biochemical evidence support the hypothesis that amyloid formation from wild-type or 1 of 80 sequence variants of transthyretin causes the human amyloid diseases senile systemic amyloidosis or familial amyloid polyneuropathy, respectively. The late onset and variable penetrance of these diseases has led to their designation as multigenic—implying that the expression levels and alleles of multiple gene products influence the course of pathology. Here we show that the binding stoichiometry of three interacting molecules, retinol-binding protein, vitamin A, and L-thyroxine, notably influenced transthyretin amyloidogenicity in vitro. At least 70 genes control retinol-binding protein, vitamin A, and L-thyroxine levels in plasma and have the potential to modulate the course of senile systemic amyloidosis or familial amyloid polyneuropathy.

Transthyretin sequesters amyloid protein and prevents amyloid formation
AL Schwarzman, L Gregori, MP Vitek, S Lyubski, et al.
Proc. Natl. Acad. Sci. USA Aug 1994; 91: 8368-8372. Neurobiology

The cardinal pathological features of Alzheimer disease are depositions of aggregated amyloid 13 protein (AP) in the brain and cerebral vasculature. However, the AP3 is found in a soluble form in cerebrospinal fluid in healthy individuals and patients with Alzheimer disease. We postulate that sequestration of AP3 precludes amyloid formation. Failure to sequester AP in Alzheimer disease may result in amyloidosis. When we added AP3 to cerebrospinal fluid of patients and controls it was rapidly sequestered into stable complexes with transthyretin. Complexes with apolipoprotein E, which has been shown to bind AP3 in vitro, were not observed in cerebrospinal fluid. Additional in vitro studies showed that both purified transthyretin and apolipoprotein E prevent amyloid formation.

Oxytocin

Variation in the oxytocin receptor gene is associated with behavioral and neural correlates of empathic accuracy
HR Laursen, HR Siebner, T Haren, K Madsen, R Grønlund, O Hulme, S Henningsson
Front Behavioral Neurosci 6 Dec 2014; 8(423): 1-10.
http://dx.doi.org:/10.3389/fnbeh.2014.00423

The neuromodulators oxytocin and serotonin have been implicated in regulating affective processes underlying empathy. Understanding this dependency, however, has been limited by a lack of objective metrics for measuring empathic performance. Here we employ a novel psychophysical method for measuring empathic performance that quantitatively measures the ability of subjects to decode the experience of another person’s pain. In 50 female subjects, we acquired functional magnetic resonance imaging data as they were exposed to a target subject experiencing variable degrees of pain, whilst performing an irrelevant attention-demanding task. We investigated the effect of variation in the oxytocin receptor gene (OXTR) and the serotonin transporter gene (SLC6A4) on the psychophysical and neurometric variability associated with empathic performance. The OXTR rs2268498 and rs53576 polymorphisms, but not the SLC6A45-HTTLPR, were associated with significant differences in empathic accuracy, with CC-and AA-carriers, respectively, displaying higher empathic accuracy. For OXTR rs2268498 there was also a genotype difference in the correlation between empathic accuracy and activity in the superior temporal sulcus (STS). In OXTR rs2268498CC-carriers, high empathic accuracy was associated with stronger responsiveness of the right STS to the observed pain. Together, the results show that genetic variation in the OXTR has significant influence on empathic accuracy and that this may be linked to variable responsivity of the STS.

Naturally occurring variations in maternal behavior in the rat are associated with differences in estrogen inducible central oxytocin receptors
Frances Champagne, Josie Diorio, Shakti Sharma, and Michael J. Meaney
PNAS  Oct 23, 2001; 98(22): 12736–12741.
http://pnas.org/cgi/doi/10.1073/pnas.221224598

Naturally occurring variations in maternal licking/grooming influence neural development and are transmitted from mother to female offspring. We found that the induction of maternal behavior in virgin females through constant exposure to pups (pup sensitization) was significantly shorter in the offspring of High compared with Low licking/grooming mothers, suggesting differences in maternal responsivity. In randomly selected females screened for individual differences in maternal responsivity and subsequently mated, there was a significant and negative correlation (r520.73) between the latency to exhibit maternal behavior in the pup sensitization paradigm and the frequency of pup licking/grooming during lactation. Females that were more maternally responsive to pups and that showed increased levels of pup licking/grooming also showed significantly higher oxytocin receptor levels in the medial preoptic area, the lateral septum, the central nucleus (n.) of the amygdala, the paraventricular n. of the hypothalamus, and the bed n. of the stria terminalis. Intra-cerebroventricular administration of an oxytocin receptor antagonist to mothers on postpartum day 3 completely eliminated the differences in pup licking/grooming, suggesting that differences in oxytocin receptor levels are functionally related to maternal behavior. Finally, estrogen treatment of virgin females significantly increased oxytocin receptor binding in the medial preoptic area and lateral septum of female offspring of High, but not Low, licking/grooming mothers. These findings suggest that maternal licking/grooming influences the development of estrogen sensitivity in brain regions that regulate maternal behavior, providing a potential mechanism for the intergenerational transmission of individual differences in maternal behavior.

Life in groups: the roles of oxytocin in mammalian sociality
Allison M. J. Anacker and Annaliese K. Beery
Front Behavioral Neurosci Dec2013; 7(185): 1 – 10.
http://dx.doi.org:/10.3389/fnbeh.2013.00185

In recent decades, scientific understanding of the many roles of oxytocin (OT) in
social behavior has advanced tremendously. The focus of this research has been on maternal attachments and reproductive pair-bonds, and much less is known about the substrates of sociality outside of reproductive contexts. It is now apparent that OT influences many aspects of social behavior including recognition, trust, empathy, and other components of the behavioral repertoire of social lspecies. This review provides a comparative perspective on the contributions of OT to life in mammalian social groups. We provide background on the functions of OT in maternal attachments and the early social lenvironment, and give an overview of the role of OT circuitry in support of different mating systems. We then introduce peer relationships in group-living rodents as a means for studying the importance of OT in non-reproductive affiliative behaviors. We review species differences in oxytocin receptor (OTR )distributions in solitary and group-living species of South American tuco-tucos and in African mole-rats, as well as singing mice. We discuss variation in OTR levels with seasonal changes in social behavior in female meadow voles, and the effects of OT manipulations on peer huddling behavior. Finally, we discuss avenues of promise for future investigation, and relate current findings to research in humans and non-human primates. There is growing evidence that OT is involved in social selectivity, including increases in aggression toward social outgroups and decreased huddling with unfamiliar individuals, which may support existing social structures or relationships at the expense of others. OT’s effects reach beyond maternal attachment and pair bonds to play a role in affiliative behavior underlying “friendships”, organization of broad social structures, and maintenance of established social relationships with individuals or groups.

Relative conformational rigidity in oxytocin and [1-penicillamine]-oxytocin: A proposal for the relationship of conformational flexibility to peptide hormone agonism and antagonism
Jean-Paul Meraldi, Victor J. Hruby, and Anne I. Richard Brewster
Proc. Natl. Acad. Sci. USA Apr 1977;  74(4): 1373-1377, Biochemistry

A comparative study of the proton and carbon-13 nuclear magnetic resonance spectral parameters of the peptide hormone oxytocin and of its competitive inhibitor [1-L-penicillamineloxytocin has been made, and the results analyzed in terms of comparative conformational and dynamic properties. The results indicate that oxytocin has a flexible conformation, while [1-L-penicillamineJoxytocin has a more restricted conformation. The results provide a framework for understanding the mechanism of peptide hormone agonism and antagonism for these compounds, and an approach for understanding some features of the interaction of the hormone and related compounds with their receptor.

Relation of the Conformation of Oxytocin to the Biology of Neurohypophyseal Hormones
Roderich Walter, I. L. Schwartz, J. H. Darnell, And D. W. Urry
Proc. Nat. Acad. Sci. USA  Jun 1971; 68(6): 1355-1359.

The conformation of oxytocin is related to the evolution and to some of the biological activities of neurohypophyseal hormonal peptides. On the basis of the three-dimensional structure, positions 3, 4, 7, and 8 are the only loci at which naturally occurring neurohypophyseal peptides may be expected to differ. The side chains of these amino-acid residues are the primary determinants of the differential specificity in interactions between neurohypophyseal hormones and their receptors.
There are three general groups of structural modifications of neurohypophyseal hormones which can be correlated with specific changes in biological activity: (a) those affecting the stabilization of the backbone of the peptide, which would extensively perturb the spatial relationships among all the constituent amino acids and hence, affect both affinity and intrinsic activities uniformly; (b) those which, while retaining the stability of the backbone conformation, alter the steric environment and charge distribution of limited surface areas, and thereby can affect affinity and intrinsic activity differentially; and (c) those changing the steric and electronic requirements of moieties comprising the active surface of the neurohypophyseal peptide, without perturbing the peptide backbone of the hormone molecule and, hence, affecting intrinsic activity without altering affinity.

The Nonpeptide Oxytocin Receptor Agonist WAY 267,464: Receptor-Binding Profile, Prosocial Effects and Distribution of c-Fos Expression in Adolescent Rats
C. Hicks, W. Jorgensen, C. Brown, J. Fardell, J. Koehbach, C. W. Gruber, et al.
J Neuroendocrinol. Jul 2012; 24(7): 1012–1029.
http://dx.doi.org:/10.111/j.1365-2826.2012.02311.x.

Previous research suggests that the nonpeptide oxytocin receptor (OTR) agonist WAY 267,464 may only partly mimic the effects of oxytocin in rodents. The present study further explored these differences and related them to OTR and vasopressin 1a receptor (V1aR) pharmacology and regional patterns of c-Fos expression. Binding data for WAY 267,464 and oxytocin were obtained by displacement binding assays on cellular membranes, while functional receptor data were generated by luciferase reporter assays. For behavioral testing, adolescent rats were tested in a social preference paradigm, the elevated plus-maze (EPM) and for locomotor activity changes following WAY 267,464 (10 and 100 mg/kg, i.p.) or oxytocin (0.1 and 1 mg/kg, i.p.). The higher doses were also examined for their effects on regional c-Fos expression. Results showed that WAY 267,464 had higher affinity (Ki) at the V1aR than the OTR (113 versus 978 nM). However, it had no functional response at the V1aR and only a weak functional effect (EC50) at the OTR (881 nM). This suggests WAY 267,464 is an OTR agonist with weak affinity and a possible V1aR antagonist. Oxytocin showed high binding at the OTR (1.0 nM) and V1aR (503 nM), with a functional EC50 of 9.0 and 59.7 nM, respectively, indicating it is a potent OTR agonist and full V1aR agonist. WAY 267,464 (100 mg/kg), but not oxytocin, significantly increased the proportion of time spent with a live rat, over a dummy rat, in the social preference test. Neither compound affected EPM behaviour, whereas the higher doses of WAY 267,464 and oxytocin suppressed locomotor activity. WAY 267,464 and oxytocin produced similar c-Fos expression in the paraventricular hypothalamic nucleus, central amygdala, lateral parabrachial nucleus and nucleus of the solitary tract, suggesting a commonality of action at the OTR with the differential doses employed. However, WAY 267,464 caused greater c-Fos expression in the medial amygdala and the supraoptic nucleus than oxytocin, and lesser effects in the locus coeruleus. Overall, our results confirm the differential effects of WAY 267,464 and oxytocin and suggest that this may reflect contrasting actions of WAY 267,464 and oxytocin at the V1aR. Antagonism of the V1aR by WAY.

Direct identification of human oxytocin receptor- binding domains using a photoactivatable cyclic peptide antagonist: Comparison with the human V1a vasopressin receptor
C Breton, H Chelli, M Kabbaj-Benmansour, E Carnazzi, et al.
J. Biol. Chem. May 3, 2001 M102073200
http://dx.doi.org:/10.1074/jbc.M102073200

Understanding of the molecular determinants responsible for antagonist binding to the oxytocin receptor should provide important insights that facilitate rational design of potential therapeutic agents for the treatment of preterm labor. To study ligand-receptor interactions, we used a novel photosensitive radio-iodinated antagonist of the human oxytocin receptor, termed [125I]-ZOTA. This ligand had an equivalent high affinity for human oxytocin and V1a vasopressin receptors expressed in CHO cells. Taking advantage of this dual specificity, we conducted photo-affinity labeling experiments on both receptors. Photo-labeled oxytocin and V1a receptors appeared as a unique protein band at 70-75 kDa and two labeled protein bands at 85-90 kDa and 46 kDa, respectively. To identify contact sites between the antagonist and the receptors, the labeled 70-75 kDa and the 46 kDa proteins were cleaved with CNBr and digested with Lys-C and Arg-C endoproteinases. The fragmentation patterns allowed to identify a covalently labeled region in the oxytocin receptor transmembrane domain III, consisting of the residues Leu114-Val115-Lys116. Analysis of contact sites in the V1a receptor led to the identification of the homologous region, consisting of the residues Val126-Val127-Lys128. Binding domains were confirmed by mutation of several CNBr cleavage sites in the oxytocin receptor and of one Lys-C cleavage site in the V1a receptor. The results are in agreement with previous experimental data and three-dimensional models of agonist and antagonist binding to members of the oxytocin/vasopressin receptor family.

Presynaptic modulation by metabotropic glutamate receptors of excitatory and inhibitory synaptic inputs to hypothalamic magnocellular neurons.
Schrader, L. A. and J. G. Tasker.
J. Neurophysiol. 1997; 77: 527–536.

The effects of activation of metabotropic glutamate receptors (mGluRs) on synaptic inputs to magnocellular neurons of the hypothalamic supraoptic nucleus (SON) were studied with the use of whole cell patch-clamp and microelectrode recordings in acute hypothalamic slices.

These data indicate that mGluRs in the hypothalamus have opposing actions at somata/dendrites and at presynaptic terminals. Activa- tion of group I receptors (mGluR1 and/or mGluR5) on presynaptic somata/dendrites led to an increase in spike-dependent transmitter release, whereas activation of the group III receptors (mGluR4, 7, and/or 8) on presynaptic terminals suppressed glutamate and GABA release onto SON neurons. No diffferences were seen in the effects of mGluR activation between immunohistochemically oxytocin and vasopressin neurons of the SON.

Postsynaptic mechanism of depression of GABAergic synapses by oxytocin in the supraoptic nucleus of immature rat
A. B. Brussaard, K. S. Kits and T. A. de Vlieger
Journal of Physiology 1996; 497(2): 495-507

  1. Oxytocin is known to act on autoreceptors of oxytocin neurons in the supraoptic nucleus (SON). We investigated whether oxytocin modulates putative oxytocin neurones by suppressing the GABAA receptor-mediated synaptic inputs on these cells.
  2. GABAergic inhibitory postsynaptic currents (IPSCs) were recorded from SON neurons in hypothalamic slices from young rats. Oxytocin specifically reduced the amplitude of both spontaneous and evoked IPSCs, without altering their current kinetics.
  3. The effect of oxytocin was observed in 70% of the magnocellular neurons recorded from the dorsomedial part of the SON. d(CH2)5OVT, a specific antagonist of oxytocin receptors, blocked the effect of oxytocin on the IPSCs. Vasopressin had no effect on oxytocin-sensitive SON neurons.
  4. The intervals between spontaneous IPSCs were not affected by oxytocin. This suggested that oxytocin had a postsynaptic effect on SON neurons.
  5. This postsynaptic origin was further substantiated by application of TTX, which blocked all evoked release but did not prevent the suppressive effect of oxytocin on the amplitude of the spontaneous IPSCs still present in the recording. The selective effect of oxytocin on IPSC amplitude was also maintained in nominally zero extracellular calcium.
  6. Intracellulax perfusion of SON neurones with GTPyS mimicked the effect of oxytocin on IPSCs, while GDP/6S, similarly applied, abolished the effect of oxytocin.
  7. Application of calcium mobilizers such as thapsigargin and caffeine also reduced the amplitude of spontaneous IPSCs without significantly altering the frequency at which IPSCs occurred.
  8. Thus, oxytocin depresses GABAergic synapses in the SON via modulation of the postsynaptic GABAA receptors. This would lead to disinhibition of SON neurons sensitive to oxytocin and could, therefore, be a powerful means of controlling the firing of oxytocin neurons.

Oxytocin, vasopressin and sociality
CS Carter, AJ Grippo, H Pournajafi-Nazarloo, MG Ruscio and SW Porges
Progress in Brain Research 2008; 170:331-36.
http://dx. doi.org:/10.1016/S0079-6123(08)00427-5

The neurobiology of social behavior is interwoven with autonomic, endocrine and other homoeostatic processes responsible for the adaptive functions of reproduction and survival. Young mammals are dependent on their mothers for nourishment, and the interaction between the mother and infant may be a physiological and neuroendocrine prototype for mammalian sociality. Although these adaptive functions of the mother–infant social behavioral dyad are obvious, adult social interactions, including social bonds, also are important to health and survival. Two neuropeptides, oxytocin (OXT) and arginine vasopressin (AVP), have been repeatedly implicated in mammalian social behaviours and emotional states that support sociality. Although best known for their roles in reproduction and homoeostasis, these peptides play a central role in the activation and expression of social behaviours and emotional states. Recent studies from our work with the prairie vole (Microtus ochrogaster), reviewed here, reveal a role for both OXT and AVP in behavioral and endocrine changes during social interactions, and also changes that are associated with the absence of social interactions (i.e. social isolation).

Serotonergic Neurotransmission in Autism Spectrum Disorders, Autism – A Neurodevelopmental Journey from Genes to Behaviour, Dr. Valsamma Eapen (Ed.), ISBN: 978-953-307-493-1, InTech, Available from: http://www.intechopen.com/books/autism-a-neurodevelopmental-journey-fromgenes-to-behaviour/serotonergic-neurotransmission-in-autism-spectrum-disorders

Chapter 5. Serotonergic Neurotransmission in Autism Spectrum Disorders
Yoshihiro Takeuchi
3.7 Oxytocin and autism spectrum disorders, pp96-97

Oxytocin is a peptide hormone produced by neurosecretory cells at the hypothalamus supraoptic nucleus and paraventricular nucleus in mothers and it is secreted from the posterior pituitary lobe. The hormone exhibits a variety of functions in the brain, as well as roles in delivery and galactopoiesis. Oxytocin regulates emotion in the company of somebody and oxytocin concentrations in the blood are low in autism spectrum disorders patients, therefore, the hormone attracts the most attention in investigations of the pathogenesis of autism spectrum disorders (Kirsch. et al; 2005). Oxytocin plays a role in signal transmission between the mother and the fetus so that neurons in the fetus are prepared for delivery. Oxytocin temporarily switches intracerebral GABAergic neurotransmission from the excitatory to inhibitory state in the fetus at delivery and exerts neuroprotective action. Serotonin fiber endings are abundant on oxytocin neurons at the hypothalamus supraoptic nucleus and paraventricular nucleus, and it should be noted that oxytocin neurons are regulated by the serotonin neuron system.

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